ETA-6 Assures Quick Transfer

Harrington HVI promises admission to UH Cleveland Medical Center within six hours for complex cardiac, vascular cases 

Sam Moghbelli, MD, sends his most complex cardiac patients to University Hospitals Cleveland Medical Center (CMC) from Marietta, a town on the Ohio River over 150 miles away. As with any emergency, the cardiologist expects a prompt response – and he knows University Hospitals Harrington Heart & Vascular Institute can deliver.

Whether it’s a Ross procedure, a mitral valve stenosis and regurgitation condition or an aortic aneurysm on the verge of rupturing, Dr. Moghbelli turns to the expertise of UH Harrington HVI.

“If it’s a surgery not offered here locally, patients need to be transferred to Cleveland for a higher level of care at a tertiary care center,” says Dr. Moghbelli, who specializes in heart failure and has a dual role on the medical staffs of both Marietta Memorial Hospital and UH. He added that he receives very positive feedback from patients who appreciate the collaboration with UH Harrington HVI for the highest level of care when need. “They’re happy they can get the emergency high-level care at University Hospitals.”

A new initiative known as ETA-6 ensures admission to UH Cleveland Medical Center from hospitals across Ohio for the most critical cardiac and vascular patients within six hours. Effective Transfers Accepted within six hours (ETA-6) has been a collaborative effort between Harrington HVI and leaders at CMC to designate more beds for heart and vascular patients. With more Lerner Tower beds allocated, Harrington HVI now can accommodate patients in 90 beds on LT 3, 5 and 7, as well as in 50 beds in the Cardiothoracic ICU, Cardiac ICU and Heart Failure ICU. The goal is to eliminate the waitlist for patients.

Drs. Ravi Ramani, left and Michael Zacharias of Harrington Heart & Vascular Institute.

“The ETA-6 initiative was created to help address and facilitate transfers in a timely fashion, whether they are coming from within the UH health system or outside,” said Michael Zacharias, DO, FHFSA, FACC, who is leading this project with fellow cardiologist Ravi Ramani, MD, MMM. “We hope to facilitate transfers within six hours as we feel this will result in the timely evaluation and care for those patients who need the specialized services offered at CMC. There has been a growing need for the specialized heart and vascular care that is offered at Cleveland Medical Center.”

Referrals to CMC come from a large geographic area beyond Northeast Ohio, including Toledo, Akron/Canton, Youngstown and Marietta. High-risk patients may include those requiring complicated percutaneous cardiac or valve procedures, cardiac surgery including complicated revascularization or valve surgery, or those in need of advanced heart failure therapies including LVAD and heart transplant.

 “The chances of a good outcome decrease with time, and we were losing patients to other perhaps less-qualified centers,” said Dr. Ramani, who has recently had both aortic dissection and heart failure patients transferred from outside the system through ETA-6. “We are leveraging the entire (Harrington Heart & Vascular) Institute so there are no more silos. For example, a potential cardiac surgery patient could be placed in any Harrington HVI bed. This is transformative.”

The clock starts when the transfer center receives the call and gets the accepting physician on the telephone. The goal is to get these patients admitted and transferred within six hours.

Ataul Qureshi, MD, a heart failure specialist at Aultman Hospital in Canton, has been sending heart failure, LVAD and transplant patients to UH for more than three years. He thinks highly of UH Harrington HVI.

“I’ve always been able to get the patients in at UH, but it’s good to know there’s a new initiative and more incentive on your end,” Dr. Qureshi said.

Drs. Ramani and Zacharias credited leadership with making this a priority.

“The beds are full every day,” Dr. Zacharias said.