Ruth Fisher MBA Henry Ford Health System Vice President Heart and Vascular Services Detroit MI Detroit C ardiogenic S hock I nitiative Detroit CSI What is Detroit CSI How did we start ID: 1010716
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1. Abiomed ELAB Meeting March 3, 2017Ruth Fisher, MBAHenry Ford Health SystemVice President Heart and Vascular ServicesDetroit, MI
2. DetroitCardiogenicShockInitiative
3. Detroit CSIWhat is Detroit CSIHow did we startWhat are the resultsKey factors for our successHow to start in your market
4. This is what people think Detroit looks like
5. This is what Detroit really looks like
6. What Detroit really looks like
7. Henry Ford Health SystemFounded in 1915 by Henry Ford
8. Detroit CSI 5 competing hospitals systems8 participating hospital locations
9. DETROIT CARDIOGENIC SHOCK INITIATIVE DETROIT CSIDetroit Metro – 4.6M Population
10. What is Detroit CSIInitiative led by cardiovascular leaders at 5 competing hospitalsGoal to reduce mortality in Cardiogenic shock patientsDeveloped new Shock treatment protocol30 patient trial
11. How did we start?Visionary leader- 30 years in DetroitCreated a call to actionPartnered with Abiomed to help collect dataDr. William O’Neill, MD
12. Meeting of the familiesWe can do betterQuarterly meetings“Leave your ego at the door”Review current literature/dataCase discussionProtocol refinement
13. Mortality after onset of Shock
14. Basir, Dixon, O’Neill et al. AJC. 2017Early support leads to higher survival
15. Basir, Dixon, O’Neill et al. AJC. 2017Fewer inotropes - higher survival rates
16. Support first then PCI?
17. ProtocolHemodynamic support with device BEFORE PCI“Door to Support Time” trackedMeasure cardiac output before and afterReduce use of inotropes
18.
19. Pilot StudyJuly, 2016 – January, 2017N = 30Sites:St Joseph's Pontiac (N=10)Beaumont Royal Oak & Troy (N=9)Henry Ford (N=6)Detroit Medical Center (N=5)DemographicsAge 63 +/- 13 years (36-87)80% Male, 20% FemaleDiabetics 48%
20. Pre-Procedural CharacteristicsTransfer from outside hospital 31% (N=9/29)4 patient transported with IABP26% (N=8/30) In Hospital Cardiac Arrest23% (N=7/30) Required CPR67% presented to hospital in shock (N=19/28)
21. Procedural Characteristics 4 patients under active CPR at the time of Impella implantation75% survival (N=3/4)AMI to Shock Time (N=13)93 minutes100% Femoral AccessShock to Device Time (N=23)64.6 minutes (8-229)
22. OutcomesCardiac Power 0.56 (Pre) (n=15)0.90 (Post) (n=20)38% improvement in Cardiac Power Output38%
23. Survival Rates Pre and Post Study
24. CARDIOGENIC SHOCK A CHANGE IN PARADIGMDOOR TO BALLOON DOOR TO SUPPORT
25. News Conference Feb 8, 2017
26. News Conference
27. News ConferenceDetroit CSI team
28. Grateful patient
29. News Conference"This is exciting because for the first time in two decades, we've found a way to save lives" of cardiogenic shock patients, said Theodore Schreiber, M.D., president of the DMC Heart Hospital
30. Media HitsFox 2 TVTop metro Detroit cardiologists team up to test new heart pump Detroit Free Press NewspaperDetroit hospitals see hope for heart attacks with new pump Crain’s Detroit Business Business News MagazineMetro Detroit cardiologists work together to improve heart attack survival rates Detroit NewsHealth systems: New heart attack treatment saving live WWJ RadioCritical Mention clip: WDIV RadioCardiologists announce results of 'successful effort to save lives'AP/Washington Times NewspaperCardiologists announce heart attack treatment initiative WILX in Lansing TV Cardiologists announce heart attack treatment initiative
31. Key Factors to SuccessCompetitors who were willing to collaborateVisionary leaderExperienced and highly skilled interventionalists who were comfortable with the Impella deviceWilling to share their data Abiomed support
32. How to start a shock programDetermine level of experience and comfort with the Impella device in your marketDevelop a “team” Meeting of the “families”FellowAcute PCI coordinatorCVAD registry / data coordinatorInstitutional support Hub and spoke modelHospital/ cath lab/ administrationEducation
33. Questions