Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.

Here's a Great Reason to Invest in Rural Healthcare

12/12/2016 8:54:02 AM | 0 comments

When a heart attack strikes, reaching the hospital quickly can mean the difference between life and death. Research shows that for every six miles a patient must travel, the risk of death increases by 1 percent.
 
That might sound like bad news for Central Valley citrus farmer Bruce Wileman, who suffered a serious heart attack at home. When the chest pain started, he was working on his ranch in Exeter, Calif. — 54 miles from the nearest major city.
 
Fortunately, Wileman received advanced emergency and cardiac care at nearby Kaweah Delta Medical Center. He's living proof that community and regional hospitals can save lives — especially when they invest in the very best equipment and medical staff.
 
Here's his inspiring story.
 

Trouble on the Farm

 
Wileman, 65, is a long-time resident of Exeter. He and his wife Sandy raised three sons there. Farming is a family tradition, and Wileman currently runs a citrus business growing and packing fruit. "We have all the varieties: navel, mandarin, everything," he said of his orange crop.
 
Having spent most of his life farming, Wileman was no stranger to hard physical work. But in the summer of 2016, he started to feel tired and run down for no apparent reason. "I don’t take any medication," he said. " I get up early in the morning. I go to bed fairly early in the evening. I usually feel pretty good. So I knew something was wrong."
 
Tired or not, Wileman had work to do around the ranch. A few days after the tiredness set in, he went out with one of his sons to wrap up some chores. Around 11:30 a.m., he started to feel overwhelmed by the morning heat. "I thought I'd sit down in the shade for a bit," he said. "And that's when my chest started hurting."
 
Wileman recognized that he was in danger and needed to go to the hospital. Fortunately, his levelheaded wife Sandy took charge. "She does really well in those kinds of situations," Wileman said. "She made the call ahead of time to let them know we were on our way."
 

Excellence Close to Home

 
Bruce's family drove him to Kaweah Delta Medical Center, located 12 miles away in Visalia. During the drive, his chest pain intensified.
 
His family was nervous. But although they didn't know it, Bruce's care team was already preparing for his arrival, thanks to Sandy's call.
 
"With a potential heart attack victim on his way, we quickly pulled together the highly specialized team for the services we knew would be needed," Kaweah Delta ED Medical Director Scott Whitlow, DO, wrote in a recent op-ed for the Visalia Times-Delta. "When Bruce and his family came through that door, we were ready."
 
The Kaweah Delta Medical Center ED team is accustomed to highly emergent, complex cases. The hospital's standout services and large catchment area draw 90,000 ED visits a year, making it one of the busiest in California. Emergency services are managed by CEP America, which also coordinates Kaweah Delta's emergency medicine, family medicine, and transitional-year residencies.
 
To better serve its expansive patient base, Kaweah Delta has invested in advanced services and technologies. In 2009, it was designated a Level 3 Trauma Center — the only such facility in the 110 miles between Bakersfield and Fresno. It's also the only hospital in the area that can offer a full range of cardiovascular services, including open-heart surgery.
 
And while Kaweah Delta may be far from the big city, its approach to patient care is decidedly progressive. "Because we know patients suffering heart attacks can’t wait for a room or care team, Kaweah Delta offers not one but four cardiovascular labs — more than any other hospital in our region," Whitlow said.
 

Dodging the Widow Maker

 
That was exactly how things played out for Wileman. Within minutes of arrival, he was resting in an ED bed, fitted with an advanced EKG monitor capable of detecting heart damage, and talking to an interventional cardiologist. "He's a really nice guy," Wileman said of that doctor, who went on to care for him throughout his stay. "He explained everything he did. He's got a great reputation here in town."
 
Wileman was transferred to the cath lab for evaluation. The results were unnerving. "Those tests showed us that he'd arrived in the nick of time," Whitlow said. "One of his coronary arteries was 100 percent closed."
 
"They called it the widow maker," Wileman said, referring to the critical blockage of the left main coronary artery, which carries a high mortality rate if left untreated.
 
Seeing the danger, the cardiology team acted immediately. They performed a coronary angioplasty and inserted a stent to help prevent future blockage. The procedure was a success. Wileman spent two nights in the hospital before heading home.
 
The cardiologist told Wileman he was lucky. Whitlow agreed: "Had it not been for Kaweah Delta, Bruce would have had to travel another 45 minutes or longer to get care. In that same amount of time, we had already admitted, diagnosed, and begun treatment."
 

Road to Recovery

 
Teamwork between CEP emergency physicians and Kaweah Delta cardiologists made a crucial difference in the hour following Wileman's heart attack. During his recovery, he continued to benefit from the hospital's commitment to clinical integration.
 
"Everywhere he went, he was cared for by doctors and nurses who knew exactly what procedure had been performed and medications administered, resulting in well-coordinated and seamless transitions from the ED to discharge and beyond," Whitlow said. "This level of collaborative care not only helped save Bruce’s life, it helped him return home just two days after his heart attack."
 
Three weeks after meeting the widow maker, Wileman was walking twice a day and feeling surprisingly well. "I learned that I need to exercise more and watch what I eat," he said. "I actually feel better today than before it happened."
 
He had high praises for the entire care team at Kaweah Delta. "I think that I was fortunate that I got there fast, they got it diagnosed, and they got me where I needed to be," he said. "I probably couldn’t have gone too much longer. I would definitely recommend them to anyone."


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