Reperfusion of Acute Myocardial Infarction in Carolina Emergency Departments (RACE)
 The Reperfusion of Acute Myocardial Infarction in Carolina Emergency Departments (RACE) project is a collaborative effort to increase the rate and speed of coronary reperfusion through systemic changes in emergency care. The project is based upon the collaborative efforts of EMS personnel, physicians, nurses, administrators, and payers from five regions and 68 hospitals throughout North Carolina. The recommendations of this project are based upon established guidelines, published data, and the knowledge and experience of numerous individuals specializing acute myocardial infarction care.
An Update on RACE
Reperfusion of Acute Myocardial Infarction in Carolina Emergency Departments (RACE)
The RACE project is a collaborative effort to increase the rate and speed of coronary reperfusion through systemic changes in emergency care. The project is based upon the collaborative efforts of EMS personnel, physicians, nurses, administrators, and payers from five regions and 68 hospitals throughout North Carolina. The recommendations of this project are based upon established guidelines, published data, and the knowledge and experience of numerous individuals specializing acute myocardial infarction care. Key collaborators in this project include the councilors of the NC Chapter, and in particular Drs. Colavita, Babb, Bohle, and Hathaway; Dr. James Jollis who is co-director of the project; Mayme Lou Roettig who is executive director; and cardiology and emergency care leaders from the five regions.
Over the two years of the program, physicians collected information on 2,000 patients, measuring pre and post-intervention times for key processes: the time from when the patient arrives at the hospital door to either angioplasty or clot-busting therapy, and the time it takes for a patient at a feeder hospital to enter and leave the transferring hospital, and the time a patient enters a feeder hospital to treatment at a second, receiving hospital. Times improved substantially in all areas.
- Median time from door to treatment for hospitals offering angioplasty fell from 85 to 74 minutes. (22 percent)
- Median time from door to infusion of clot-busting therapy fell from from 35 to 29 minutes. (17 per cent)
- Median time from door-in to door-out at transfer hospitals fell from 120 to 71 minutes. (41 per cent)
- Median time from arriving at a feeder hospital to beginning treatment at a receiving hospital fell from 149 minutes to 106 minutes. (29 per cent)
View the AP story that also appeared in the Philadelphia Inquirer, NY Times and more than 400 other news outlets.
View the FOX News story.
All RACE Meeting, Greensboro, NC, October 5, 2006
Charles Wilson, MD, the Medical Director for Moses-Cone Heart Center and Co-Medical Director for the Durham/Greensboro/Chapel-Hill (DGC) RACE Region welcomed the state RACE working group to Greensboro and invited all who would like a tour of the new Heart Center to join him after the ALL-RACE Meeting. Click here for more.
For more information on RACE view the presentations below. All presentations have been converted to PDF Format. The PDF Download will begin automaticall when you click a link below
Optimal System Specification by Point of Care Operations Manual – Download PDF.
RACE Poster - Download JPG
RACE Referring Hospitals Data Collection Form- Download PDF
News Release
For Immediate Release Contact: BCBSNC Rita Simonetta
Nov. 1, 2005 Duke University Medical Center Richard Merritt
Blue Cross and Blue Shield of North Carolina and Statewide Health Care Consortium Team Up to Win the Race Against Heart Attacks
Duke Medical Center-founded initiative to improve care for heart attack patients
in North Carolina emergency rooms
Durham, N.C. – A consortium of North Carolina health care providers and Blue Cross and Blue Shield of North Carolina (BCBSNC) today announced details of a collaborative project to improve the survival rate of patients rushed to the hospital with heart attacks. The consortium, which includes physicians, hospitals and emergency medical services professionals, is launching a new effort called Reperfusion of Acute MI in Carolina Emergency departments (RACE).
“RACE is the most extensive effort in the nation to improve care of heart attack patients by organizing ambulances, emergency departments and hospitals to provide the best treatments,” said Duke University Medical Center cardiologist and RACE co-medical director Christopher Granger, M.D. “In North Carolina, it gives us the opportunity to do a much better job treating heart attacks to improve survival.”
The issue is especially important in North Carolina, team members said, since national registries have shown that only about 60 percent of North Carolinians who come to an emergency room receive potentially life-saving reperfusion therapies for a myocardial infarction (MI), or heart attack, compared to the national average of at least 70 percent. The RACE project could also serve as a national model for collaborative efforts to improve the delivery of emergency care.
The North Carolina consortium comprises five regions centered in Greenville, Chapel Hill/Durham, Greensboro/Winston-Salem, Charlotte and Asheville. Each region consists of networks of emergency medicine ambulance systems, smaller hospitals and referral hospitals. Other partners in the project include the Duke Clinical Research Institute of Duke University Medical Center and the North Carolina chapter of the American College of Cardiology.
“This project will help save lives in North Carolina,” said Robert Harris, M.D., senior vice president of health care services and chief medical officer for BCBSNC, which is supporting the effort with a $1 million corporate grant. “What we are facing in North Carolina is a microcosm of what is happening in the country as a whole – we know that world-class medical services and treatments are available, yet we seem to have a problem with timely access and coordination.”
“Unlike some national efforts that attempt to deal with this issue from afar, we are actually in the trenches trying figure out what works the best,” said Duke cardiologist and RACE co-medical director James Jollis, M.D. “Much time has been spent over the years conducting clinical trials to figure out what works for heart attack patients. Now, we are trying to put into practice what we all know – that opening arteries quickly saves lives. We have hit a wall at treating about 60 percent of eligible patients and we’re not improving much more – we believe we can do better.”
Throughout the course of the two-year project, RACE researchers will collect data on heart attack patients – both those who received treatment and those who would have been candidates for reperfusion therapy, but did not receive it. RACE’s goal is to provide each facility with feedback to aid streamlining patient evaluation and treatment.
Reperfusion therapies involve using either a clot-busting drug or a catheter, in an operation called an angioplasty. These therapies unblock clogged coronary arteries, sparing heart muscle from damage due to lack of oxygen. While clot-busting, or thrombolytic, drugs are available at most hospitals and emergency rooms, angioplasty is not as widely available. Angioplasty has been found to be more effective than thrombolytics in reopening arteries when performed within 90 minutes of a patient’s arrival to the hospital.
RACE plans to improve outcomes of heart attack patients by funding educational nursing programs, conducting physician teleconferencing seminars on reperfusion therapies, providing emergency room guideline tools and expanding the use of electrocardiogram (EKG) machines in ambulances, so vital data about patients’ hearts can be transmitted ahead to emergency personnel.
The program will also analyze health care delivery systems at participating hospitals. While many larger centers have layers of service and personnel that provide round-the-clock care, some smaller hospitals do not treat many heart patients and may not be optimally staffed for emergencies, team members said. The program has established a 24-hour hotline administered by senior cardiologists who can consult with emergency room physicians at smaller hospitals lacking an on-site cardiologist available 24 hours a day.
RACE Participants - Click here for Race Sites
RACE Regional Coordinators:
Asheville:
Lourdes Lorenz, RN
Missions Hospital, Inc
509 Biltmore Ave.
Asheville, NC 28801
lourdes.lorenz@msj.org
Jan Bebe
Executive Assistant to:
Sonya Greck, Vice President Regional and Heart Services
Mission Hospitals, Inc.
509 Biltmore Avenue
Asheville, NC 28801
jadjtb@msj.org
Charlotte:
Marla Jordan, RN, BSN
5738 Settlemyer Court
Charlotte, NC 28212
marla.jordan@duke.edu
Durham/Chapel Hill/Greensboro:
Based at Duke in Durham
Jenny C. Underwood, RN, BSN, CCRN
3100 Tower Blvd., Suite 600, Box 80/3229
Durham, NC 27707
jenny.underwood@duke.edu
Greenville:
Mary Printz, MSN, FNP-C
AMI Outreach Coordinator
Pitt County Memorial Hospital - Cardiovascular Center
2100 Stantonsburg Rd.
Greenville, NC 27834
MPrintz@PCMH.COM
Winston-Salem:
Lisa Monk, RN
Forsyth Medical Center
3333 Silas Creek Parkway
Winston-Salem, NC 27103
lmmonk@novanthealth.org
Stephanie Starling-Edwards, RN, BSN
WFUBMC Heart Center Outreach Coordinator
Medical Center Boulevard
Winston-Salem, NC 27157
sedwards@wfubmc.edu
RACE Central Coordinator:
Mayme Lou Roettig, RN, MSN
Executive Director of RACE
Reperfusion in AMI in Carolina Emergency Departments
Duke Clinical Research Institute
4691 Sierra View DR
Denver, NC 28037
704-483-9922
mayme.roettig@duke.edu
RACE Sponsors
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