New CCDU streamlines cardiac patients

The establishment of the new Cardiology Clinical Decision Unit at Cookeville Regional Medical Center is required to maintain the Chest Pain Center accreditation that was obtained in July 2020.

The five-bed unit is staffed by cardiologists with the goal to streamline the diagnosis and treatment of possible cardiac patients.

“Typically, in bigger cities, the emergency department handles these units,” said Dr. Mariano Battaglia, cardiologist who joined Tennessee Heart in 2012. “It’s a way of getting people who may have cardiac issues screened quicker and if needed, get treatment in a timely manner.”

Those who are actively having heart attacks are identified and treated quickly upon arrival thanks to the establishment of Code STEMI with regional emergency medical services.

But those who have may be having other, less severe symptoms are oftentimes left waiting in the hospital for exams and results. With the CCDU, this cuts that down to just hours, which limits a patient’s time in the hospital.

“Some patients may show signs of ischemia, subtle changes or no changes in EKGs or ST Elevations that don’t meet the level of a STEMI, but need to be evaluated so they don’t fall through the cracks,” Battaglia said.

When a patient comes in to the CCDU, there is a screening process that is done. Those in the lower risk category will be brought back in for an ischemic workup (stress test or other cardiac imaging modality) within 72 hours. Those in an intermediate risk category will be admitted to the CCDU and worked up quicker.

“We have expanded stress test timing and capabilities to be offered seven days a week,” said Dr. Ashley Nickerson, fellow cardiologist who worked with Battaglia on setting up the CCDU. “We also have a new modality where we can do a stress test with a bicycle and get an EKG done with higher quality echo images.”

Physicians and other emergency medical personnel – even those from outside the area – are encouraged to send patients to the CCDU for evaluation.

“The goal from the ACC is to work up and discharge patients within 18 hours,” Nickerson said. “It’s a benefit to the hospital and a benefit to the patient. This (unit) is a priority for cardiologists for fast turnaround time.”

CRMC CEO Paul Korth says the establishment of the CCDU is a great win for everyone.

“The patient gets the quality medical care needed in a more timely and efficient manner,” he said. “This forward thinking in healthcare is a win-win for everyone.”

The CCDU is open 24 hours a day, 7 days a week. Anyone can be admitted or evaluated at any time. Outside medical services can refer patients by calling the CCDU nurse practitioner through the transfer center.

“We want to expand it to offer more services as we get it off the ground,” Nickerson said.

The next ACC accreditation review is in July 2023.