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Welcome to the Becker's Healthcare podcast. I'm Mariah

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Taylor, assistant editor, and I'm thrilled to be

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interviewing Greg Reese, an interventional cardiologist at UPMC

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on the podcast today. Greg, thank you so

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much for joining me. I'm really excited to

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talk more about the work you're doing in

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cardiology care. But before we dive into that,

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I'd love you to introduce yourself and tell

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us a little bit about your background.

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Oh, thank you, Mariah, very much, for having

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me on the podcast.

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Well, let's see. I, grew up in New

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York City. I went to Penn State,

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went to Cornell Medical, and did my,

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residency fellowship training in Boston at Beth Israel

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Hospital.

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I practiced in Philadelphia for many years and,

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came to South Central Pennsylvania about eight years

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ago.

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Excellent.

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Now I hear that you over there at

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UPMC are doing some really interesting stuff in

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STEMI. So can you walk us through how

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the STEMI system is working?

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Of course. Well, we have a, STEMI alert

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system as, you know, most hospitals,

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do that have on-site interventional cardiology.

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And the way it works is we have

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a interventional cardiologist,

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at our hospital,

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all of our hospitals, but mine in particular

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is is here in York, Pennsylvania.

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We have, an interventional cardiologist on call 247,

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always within thirty minutes of the hospital.

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We also have,

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cardio cardiovascular

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technicians and nurses,

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also within thirty minutes of the hospital,

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on call twenty four seven. So

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if a patient comes into the ER

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or if the EMS team alerts us that

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they have a STEMI in the field,

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we have both activation both via cell phone

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and via,

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pagers. You know, the nineteen eighties are calling,

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and they want their technology back.

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But we have that as well because there

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are some, dead zones where cell phones don't

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work.

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So we have multiple, modes of alert, and,

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you know, the team, mobilizes

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and comes in. You know, our goal, of

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course, is to be in within thirty minutes

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and,

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to have the patient in the cath lab,

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on the table, getting the procedure, and have

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the,

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artery open, ideally within thirty minutes after that.

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There is a ninety minute,

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goal, by the

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ACC,

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door to balloon time. We we want, to

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exceed that goal,

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as much as possible, and that's, that's how

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we work in the hospital.

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Amazing. And I hear that you've done exactly

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that. Can you tell us a little bit

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more about the case where you were able

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to get a patient in in a thirty

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seven minute window from door to balloon time?

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Of course. Now that was a off hours

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case.

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So thirty seven minutes is, certainly,

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very doable if, you know, the team is

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all there. It's 10:00 in the morning. You

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have an open lab, and someone comes into

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the ER. ER identifies the patient quickly as

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a STEMI does a quick EKG,

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you know, the cath lab team can swoop

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over,

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grab the patient, get them on the table,

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and that's doable. What was unique about this

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case is it was an off hours case.

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So the key here was that the patient

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called EMS,

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that the EMS,

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providers,

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who we work closely with, you know, I,

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did an on-site EKG,

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that was

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sent to the coordinator,

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team in the ER, and the STEMI alert

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was called from the field. So we had

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time as a cardiology team to get in

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the hospital and get ready and basically to

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meet the ambulance,

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at the door.

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So that way we were able to, you

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know, get the patient

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in through the ER as quickly as possible

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on the table, instrumented,

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and get a door to balloon time of

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thirty seven minutes.

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That's incredible.

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And I'm sure as our listeners picked up

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too, there really is this emphasis on your

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team. So can you explain a little bit

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more about how your team has prepared and

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trained for exactly this kind of case and

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how you're coordinating with other teams?

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Absolutely. I mean, I think, you know, the

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emphasis,

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in STEMI care, if you're talking about even

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ACLS training, has been the importance of the

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team. It's not one person. It's not a

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cardiologist. It's not an ER doc, but it

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requires a whole, you know, whole village. You

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know, it starts with the, the EMTs who,

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you know, can get there,

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identify the patient with chest pain, do an

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on-site EKG,

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and and call the STEMI alert. It's the

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ER docs who,

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and not only the ER docs, but the

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ER nurses,

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you know, everyone from the front desk,

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to the nurses to the doctors,

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who can rapidly

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triage those patients and and get, get them

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cared for. And then it is, you know,

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cardiology team. And then after we're done with

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the patient, it's the,

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doctors and nurses in the ICU. So it

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really is a team effort to get the

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best results, not only in door to balloon

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time, but also in outcomes, patient satisfaction, etcetera,

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in the care of STEMI patients.

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Excellent.

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And it's clearly paying off because UPMC Memorial

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and UPMC

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Hanover have both earned the ACC Platinum Performance

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Achievement Award for five years in a row.

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So can you talk to us a little

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bit more about what you believe has contributed

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to that streak?

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I think what has contributed

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is that it's been a priority

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of the individual hospitals and more importantly of

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the UPMC

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system,

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to provide excellent quality care across the cardiology

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spectrum,

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in terms of STEMI care,

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congestive heart failure, other conditions.

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The platinum award,

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which, you know, we really do value is

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a recognition

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of that of that care. You know, we

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achieve that by

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analyzing all of our outcomes, you know, with

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a very critical

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viewpoint to continuous quality improvement.

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You know, we have meetings,

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once a month or more, you know, more

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often if necessary,

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where we analyze all the cases,

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all of the, STEMI cases where we analyze

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our outcomes in cardiac catheterization,

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heart failure, arrhythmia management, etcetera,

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looking for any ways in which we can

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improve. You know, improvement doesn't take place in

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leaps and bounds. It takes place in small

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steps. You know, you you get a an

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average time of

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ten minutes to EKG down to seven minutes,

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and you get,

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a minute here, a minute there.

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You get more thorough administration of medications in

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the ER and administration of medications at discharge,

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to prevent readmissions. So, you know, again, it's

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a it's a team approach, but it really

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is a dedication

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to, continuous improvement and optimizing care.

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Excellent.

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Well, thank you so much for taking the

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time to speak with me today. This was

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such an informative discussion.

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Thank you. Thank you for having me.