CEO of the American Heart Association, Nancy Brown, spoke to the Trust about Mission: Lifeline, a program of the association designed to help hospitals and EMS personnel develop comprehensive, integrated systems of care to improve outcomes for those suffering the most serious heart attacks and out-of-hospital cardiac arrest. Brown tell us what that looks like:
HCT: What is Mission: Lifeline?
Nancy Brown: Mission: Lifeline is the American Heart Association’s national initiative to advance systems of care for patients suffering from acute myocardial infarction (heart attack) and/or cardiac arrest.
On average, 935,000 Americans have a heart attack each year, and about 250,000 of those are the most severe type, ST elevation myocardial infarction. Each year, about 383,000 people suffer cardiac arrest. The statistics are a call to action!
Under optimal circumstances, it can take an ambulance about 7-10 minutes to reach the patient. That may not sound like a lot of time, but for heart attacks or sudden cardiac arrest, time is muscle. When blood flow is restricted to or shut off from the heart, the heart muscle dies. Mission: Lifeline saves lives by improving the system, saving valuable time, saving muscle and saving lives.
HCT: What is at stake?
Nancy Brown: The lives of our families, friends, co-workers and neighbors are at stake. We must overcome the barriers that prevent patients from receiving the appropriate care they need, so they can survive the deadliest of heart attacks and sudden cardiac arrest. And importantly, we cannot accept that the potential for lifesaving intervention is dependent on geography—we passionately believe that where you live shouldn’t determine if you live. The Rural Healthcare Program of the Helmsley Charitable Trust has enabled us to reach these important rural communities and is such an important partner in this work.
HCT: What results have you seen so far?
Nancy Brown: The most important results we have seen so far from Mission: Lifeline are people who are alive today, thanks to the Mission: Lifeline system of care now reaching 69% of the U.S.
We are seeing a significant increase in use of technology that enables the Emergency Medical Service (EMS) provider to transmit ECG (Electro Cardio Gram) readings immediately from the field, as soon as they reach the patient. This helps determine the right course of action for the EMS provider to take, with the least delay possible. Especially if the patient is having an ST elevated myocardial infarction (or STEMI) heart attack, the deadliest type of heart attack, the decision time afforded by using this technology can make all the difference in the results for the patient.
In South Dakota, thanks to support from the Helmsley Charitable Trust, field transmissions of ECGs have increased 161%. And the percentage of heart attack victims who receive percutaneous coronary intervention (PCI) within 90 minutes has risen from 58% to more than 93%, which represents a 35% increase in the number of potential lives saved.
Also thanks to funding from the Trust, in North Dakota, Wyoming, Minnesota and Nebraska, we are progressing on a similar path, with significant results anticipated in these states, and getting us closer to 100% of the nation covered by Mission: Lifeline.
HCT: What are the unique challenges of administering Mission: Lifeline in rural areas?
Nancy Brown: Administering Mission: Lifeline in the rural Midwest means understanding that there is no “one size fits all” solution and that implementing national recommendations on a community level means considering many local factors including geography, resources, legislation and regulation.
Our unique challenge is to improve upon the great work that is currently being delivered by healthcare providers across the program area, working collaboratively with many diverse stakeholders to establish consensus in how to approach the system of care using science-proven protocols, and then delivering the training and resources needed to put that regional or statewide system into action. Also, in rural areas, many EMS agencies are staffed by volunteers. We tailor and individualize training to ensure that the small volunteer agency is getting the same lifesaving training they can put into action, to deliver results equal to their paid counterparts.
HCT: Have there been any lessons learned from your work in the upper Midwest that you have applied more broadly to the program?
Nancy Brown: Absolutely. Because of the significant investment that the Trust has made in Mission: Lifeline programs, we have been able to take a more systematic approach in gaining a deeper knowledge of the systems of care in rural settings, which has directly helped to evolve our collaborations, training and resources; and is helping us shape future plans for rural impact. Learning from Mission: Lifeline programs in the upper Midwest has informed development of expansion into Wyoming and for new locations we’re currently exploring. Further, working with the team at the Helmsley, we have refined our process for tracking Mission: Lifeline outcomes, which has been great work together and offers application beyond our currently funded programs.
HCT: How do Mission: Lifeline and the investments made by the Trust contribute to the American Heart Association’s goal of reducing cardiovascular deaths by 20% before 2020?
Nancy Brown: We know that each year, more than half a million Americans experience STEMI or out-of-hospital cardiac arrest or both. The majority of these patients fail to receive appropriate treatment for their life-threatening conditions within recommended timeframes. Mission: Lifeline was created by the American Heart Association as a response to missed opportunities for prompt, appropriate STEMI treatment, and to save lives.
By bringing Mission: Lifeline to more states and more systems of care, we are closer than ever to reaching our goals. Together, the American Heart Association and the Helmsley Charitable Trust are overcoming the barriers that keep patients from timely access to the care they need.
HCT: What has been the role of philanthropy in growing this initiative?
Nancy Brown: As a nonprofit charity, the American Heart Association relies on the generosity of donors to fund our programs, including Mission: Lifeline. We are thankful to the Trust, and to many of our current friends who have invested in this important program. We’re particularly encouraged by the number of new donors who have begun supporting our organization in response to their excitement generated by Mission: Lifeline.
The Helmsley Charitable Trust is a highly valued partner, paving the way by providing lead funding for the initiatives. And, by challenging us to raise other funding to completely fund our program budgets, we have been able to engage more people throughout the communities served by the program.
HCT: How can other foundations contribute to bringing Mission: Lifeline to more regions?
Nancy Brown: Our goal is to bring Mission: Lifeline impact to every community across the nation, and donor support is the only way we can make this happen. Our foundation relations team is eager to explore opportunities to serve new regions. We welcome and appreciate inquiries on how we can partner with other foundations to expand Mission: Lifeline to save and improve more lives. Please contact Jill Dotts, national director of foundation relations, for more information.