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Dawn Olson, Director of Cardiovascular Services at the CardioVascular Institute of North Colorado Photography by Warren Diggles

Grim statistics but, for Northern Coloradans, there’s hope and there’s help at the CardioVascular Institute (CVI) of North Colorado at North Colorado Medical Center (NCMC). CVI is poised at the forefront of the battle being waged against this major health threat and, in its 175,000 square foot facility, offers a variety of innovative ideas in cardiovascular care. In fact, CVI offers everything from advanced diagnostic imaging to leading edge interventional cardiology and open heart surgery to an accredited cardiac rehabilitation program.

Dawn Olson, service line director in charge of cardiac operations, explains that CVI is a comprehensive, state-of-the-art heart hospital within NCMC. “We have some amazing doctors doing amazing procedures and a highly skilled nursing staff that adds to the quality of care we give our patients,” she says. “We also have the equipment that allows us to do the most up-to-date surgical procedures. We have 32 in-patient cardiac beds,” Olson says, adding, “and they are full almost all the time.”

CVI opened in November of 2005 as part of the Second Century expansion of NCMC and brought many aspects of the cardiovascular services together in one area. “We already had three cardiac surgeons and, over a two year period, have grown to a total of 13 cardiologists,” Olson says. In addition, CVI also employs over 60 support staff personnel with cath lab nurses, echo sonographers, Cardiac Rehab and non-invasive staff.

Everything is right in quick reach, Olson says. “When we built this area, we combined everything so we don’t have to run back and forth to other areas of the hospital. It’s all here.”

That was the idea, says Jim Beckmann, M.D., and CVI’s medical director. “Consolidating the cardiovascular services into one area did two things. It increased the efficiency of delivery of care to patients so we can meet their needs more quickly. It also gave us the means to be more efficient with the patients’ time.”

Expanded Options at the CVI

Olson points to a long list of options housed within CVI. Diagnostic resources include non-invasive procedures such as a 64-slice computed tomography (CAT scan), 3-D echocardiography, electrocardiography (EKG), exercise tolerance testing, nuclear stress testing, and Holter and event monitoring. Invasive procedures include cardiac catheterization, coronary and peripheral angiograms, intravascular ultrasound and doppler, trans-esophageal echo (TEE), and electro-physiology studies that include mapping of the irregular heart beats. In addition, three state-of-the-art cath labs provide diagnostic cardiac caths, angioplasty, stents, pacemakers, peripheral artery disease intervention and ICD implants.

“We also have a new gym for cardiac rehab. Patients exercise here after identification of atherosclerosis or heart attacks, and we offer them educational programs,” Olson says. “With cardiovascular disease, you have to learn to take care of yourself. Cardio rehab gives patients the tools to stay out of the hospital.”

The structure of CVI promotes collegiality among the doctors, Olson says. “Many procedures overlap and there is not a competitive factor. Everything is a team effort. We meet and discuss patient care and make the best decisions for the patient.”

Those exchanges between doctors and other healthcare professionals are fostered through a cath conference held every Thursday in the CVI Conference Room. “All the cardiologists, the surgeons, cath lab techs, everyone attends,” Olson says. The conference can take form in several ways, she says. “Any of the CVI physicians can bring in new research or a different or interesting case. We can pull up images, view cath films and EKGs. It’s a good opportunity to work together and share information and ideas.”

In some cases, doctors are teleconferenced in from other sites such as McKee and Sterling so they can participate. “Technology and medical procedures are constantly changing and we want to stay current so this is our avenue to do that,” adds Olson.

Outreach to other areas goes beyond teleconferencing, Olson says. “We now have full time cardiologists and clinics in Loveland and Sterling as well. We also serve Fort Morgan, Brush, Wray, Yuma, Holyoke and we’re just getting ready to start a clinic in Haxton. Our goal is to serve people in other communities and provide as much service as possible to their hospitals and not make them drive two hours to see us. We go to them.”

Jim Beckmann, M.D., Director of the CardioVascular Institute at North Colorado Medical Center Photography by Warren Diggles

PADnet

CVI has reached out to other communities through PADnet, a program to detect peripheral arterial disease (PAD). “Peripheral arterial disease is caused by plaque build up, mainly in the legs – in the periphery,” Dr. Beckmann explains. “People can be asymptomatic or they can just think they’re getting older and it’s normal for their legs to hurt. This program uses a non-invasive test that looks at blood flow in a patient’s legs to help diagnose the presence of plaque in the arteries.”

PAD is often under diagnosed, Olson says. “People sometimes won’t drive here to do a test so we’ve partnered with other facilities so they can perform the test there. Once that’s done, the results can be transmitted electronically to NCMC and we have a panel of doctors review them.”

“We interpret the test and give physicians feedback indicating the presence or absence of PAD and we recommend follow-up when appropriate,” says Dr. Beckmann.

CVI is the only regional provider for PADnet. “This program is not just in the Banner Health network; it’s regional and includes Julesburg, Holyoke, Yuma, Haxtun, Wray, Johnstown, Windsor and Benkelman, NE. We train them on the use of the equipment and then offer our interpretation services,” says Dr. Beckmann.

Cardiac Alert Program and Code STEMI

Partnering and teamwork underlie all of CVI’s efforts. Another indication of that is the partnership formed with the Weld County ambulance services to create a Cardiac Alert program. “Through this arrangement, the first in the region, we bring people straight into CVI where our whole cardiac team is activated. We completely bypass the Emergency Department. It’s based on the ‘time is muscle’ slogan of the American Heart Association. That basically means that the more time we save getting the patient into cardio and opening the blockage, the less damage to the heart muscle,” Olson says.

Based on the success of that program, Dr. Beckmann created Code STEMI. Code STEMI is a process that helps ensure that heart attack patients in rural communities receive timely care. Dr. Beckmann and his crew worked with 14 rural hospitals in northeastern Colorado and southwestern Nebraska, training medical professionals to follow specific protocols designed to cut down “door to reperfusion time,” whether it be a clot busting drug or transfer for balloon angioplasty.

When a patient arrives in the emergency room of a rural hospital, healthcare professionals determine if there is a blockage in blood flow to the heart – a heart attack or STEMI – and, if so, physicians call North Colorado Med Evac for helicopter transport to CVI. As part of Code STEMI, flight nurses know standardized treatment plans, communication and transfer protocols that need to be transmitted to CVI so they prepare all of that en route. A call is also made to CVI to alert the cardiologist that the patient is being transferred. The transfer is automatic without paper hold-ups and the focus remains on the patient.

“It’s a means to transfer the patient to us quickly,” Dr. Beckmann says. He developed Code STEMI after seeing how well an efficient process like Cardiac Alert served heart attack patients. “By working with emergency personnel in Weld County, we were able to streamline the care of the heart attack victims locally and get the patient the care they needed quickly. So Code STEMI has taken that out farther with a regional focus.”

Dr. Beckmann says CVI provides many advantages to patients in the region. Another such advantage is the ability to host ongoing clinical trials, Dr. Beckmann says. “We have a wide number of different trials here and each one is trying to see if a medication or device will improve the care of the patient. For example, we have trials looking at anti-coagulation and thinning the blood, trials looking at medicines for interventions in the cath lab, a trial looking at better ways to lower cholesterol. We approach patients to see if they are interested in participating, with not only the possibility of improving their own care, but also helping others coming down that same road in the future. So we can offer new drugs and devices not yet available on the market. That’s an added benefit because they can be exposed to newer things sooner.” While Dr. Beckmann says that not all patients are good candidates for clinical trials, he adds, “Most people are excited to do this.”

The bottom line, Olson says, is a high quality of patient care. “All of this gives us a chance to offer the best care possible and to look at how we can continue to improve.” +