One Mission Requires Many Partners

(This article was originally published in 2012. Note: The Society of Cardiovascular Patient Care merged with the American College of Cardiology in January 2016. The SCPC is now referred to as ACC Accreditation Services. For historical accuracy or research reference, we have retained SCPC in the timeline to prevent confusion.)

Over the years, many people have asked me about how EHAC started and how we work with other groups in order to spread the message. Many of you know my personal story, but many of you may not realize that I work with numerous organizations, agencies and governing bodies in order to help spread the message. We are not an island and we all work towards the same goal – to recognize the early signs of a heart attack in order to save a life!

I compare the EHAC movement to many other vital causes, such as those that aim to end world hunger, provide clean water and help the homeless population. These programs depend upon many important groups, agencies and volunteers that all have the same mission – to save a life. Many groups work together to create new laws, new avenues of assistance, new outreach channels and much more.

In order to save a life with the EHAC movement, I knew that we had to create a paradigm shift in the way we were treating potential victims of a heart attack. 30 years ago, unless you were having crippling chest pain, hospitals might not have seen you as a serious candidate for treatment. You would have met the GOMER mentality - "Get Out of My Emergency Room." And you would probably die if you were suffering from a heart attack.

This mentality was not necessarily the "fault" of the hospital. Many hospitals simply didn't have the pathways to treat patients in the early stages of a heart attack. However, due to the help of many, we are shifting that mentality from "GOMER" to "TUCIE - Thank You for Coming In Early."

A Brief Synopsis of Working Together
For over 30 years, I have worked with many national and international agencies, governments, organizations, hospitals and volunteers in order to spread the message. However, as the years have changed, so have the names. Here is a brief sample of some important history:
• The topic of Early Heart Attack Care was a subject of discussion by the National Heart Attack Alert Program (NHAAP) that had been formed by the National Heart Lung and Blood Institute (National Institutes of Health) and was instrumental in developing a national campaign that was called "Act in Time to Heart Attack Signs." It was formed in partnership with the American Heart Association and the American Red Cross.
• The "Act in Time" program was similar to the Early Heart Attack Care program developed first by St. Agnes Hospital in Baltimore, Maryland, and then taken over by the Society of Chest Pain Centers (now the Society of Cardiovascular Patient Care).
• In March 2002, a joint statement by the NHAAP and SCPC was sent to chest pain center hospitals emphasizing the importance of EHAC recognition as a strategy "to help prevent heart damage and save lives in their communities"
• This education was also addressed by the American College of Cardiology at their 31st Bethesda Conference on Emergency Cardiac Care in September 1999. The importance of this early care message linked the response by the chest pain emergency department to what we called the "New Paradigm" - shifting care to enhance the present day management of patients with Ischemic Heart Disease.
• A major focus was to develop a partnership between emergency physicians and cardiologists to continuously improve the treatment communication process between the teams to reduce the death rate. Through multiple groups, this partnership was to be broadcast from the hospitals in order to educate their communities about the early onset of symptoms, available resources, etc. A major focus of this strategy is addressing reasons for delay when patients are having early symptoms. One focus should be on patients presenting with central chest discomfort, not necessarily perceived as chest pain, as well as those with chest pain.

As these programs evolved, many positive outcomes were achieved:
• Observational pathways in the emergency department were created utilizing the ACC Accreditation Services accredited guidelines. Today there are over 1000 ACC accredited chest pain centers in the United States. These accredited facilities must pass stringent guidelines that include training all hospital employees to recognize the signs and symptoms to provide early heart attack care. (Key Element 1 of Cycle IV CPC Accreditation) (Note: CPC Accreditation is currently referred to as Version 6).
• The Society's Deputy Heart Attack program which disseminates Early Heart Attack Care education has over 850,000+ volunteers who have taken the test and the pledge in order to save a life.
• The Society also works with CMS on their Million Heart ABCS Program in order to save a million hearts from cardiovascular disease. This program is also promoted by the AHA.
• Over the last few years, many organizations, agencies and hospitals are using similar messages in order to save a life. One that you might instantly recognize is "Survive. Don't Drive." This powerful message can be used by anyone in order to demonstrate that the rate of survival increases if a potential victim calls 911 and receives life-saving care by EMTs. Many facilities have even started showing people how their EMTs start the treatment by using EKGs in the ambulance and report that information from the field in order to trigger the response teams.

As we proceed, we must all recognize that we are not in a silo. We must use the evolving information, medical technology, standards and all of the resources available to us in order to accomplish our mission. We continue to focus our efforts to provide the chance to save a life and provide that teachable moment that is both user-friendly and cost-effective for patients.


Dr. Raymond Bahr's Articles & Videos

Dr. Raymond Bahr writes articles about the EHAC movement. He has also done several videos that outline the importance of Early Heart Attack Care.

EHAC began in 1981 at St. Agnes Hospital in Baltimore, MD. Today, the mission of EHAC remains the same - spread the message that heart attacks have beginnings.