John Kern, MD, Chief of the Division of Cardiothoracic Surgery
When a patient has an aortic dissection, aneurysm or other aortic emergency, every second that can be cut from the time to treatment increases the likelihood of survival. That’s why UVA has instituted an Aortic Alert system for referring physicians. “This is a way for us to be ready for these patients so that the moment they hit our door, we’re prepared to take care of them,” says John Kern, MD, chief of the Division of Cardiothoracic Surgery and one of the leaders of the Aortic Alert effort. “Our goal is to get the information we need as soon as possible so we can mobilize the appropriate care team at the same time we’re expediting transfer.”
When referring physicians treating aortic emergencies call the UVA Transfer Center, operators immediately connect them to the attending cardiac or vascular surgeon serving as the aortic triage officer on call. While they are reviewing the patient’s condition, personnel from UVA’s Office of Telemedicine are patched into the call to facilitate the transfer of pertinent images to UVA radiologists. Once the call is complete, the triage officer works with the operator and emergency room physician to assemble the appropriate team, depending on where the patient needs to go: the operating room, endovascular suite, radiology or intensive care.
“It’s not just the underlying telecommunications system that sets Aortic Alert apart,” Kern says. “It’s the priority we’ve placed on direct collaboration with referring physicians — and the system we’ve created internally, spanning such services as nursing, radiology, anesthesiology and the emergency room — that makes the difference.”
In creating the Aortic Alert, Kern and his colleagues took cues from similar processes already in place at UVA such as its Stroke and STEMI Alert systems. They also collected detailed feedback from all participating services, ensuring that the triage officer can easily adjust the composition of the care team according to the nature of the emergency.
Aortic Alert is not limited to transfers, however. Physicians can use Aortic Alert to confer with UVA physicians about managing their patients. “One of our strengths at UVA is the management of aortic disease,” says Gilbert R. Upchurch Jr., MD, chief of the Division of Vascular Surgery. “We have a commitment as a quaternary care center to do whatever we can to make this expertise available to other institutions, whether it’s by consulting with physicians or accepting patients for care.”
Another purpose of establishing Aortic Alert, according to Kern, is simply to make other institutions more aware that UVA has the specialty care available to treat aortic emergencies. Measured by that criterion alone, it’s already a success. “People use it all the time,” says Upchurch. “And it is saving lives.”
To access Aortic Alert, call the UVA Transfer Center: 1.844.933.7882.