Sunday, May 5, 2013

Collaboration at the heart of patient care

The night Julie Meyerholz flew to Boston was unforgettable—even if she doesn’t remember it.

Julie and her husband were having dinner at the Nantucket airport when she started having extreme chest pains. But that’s the last thing Julie recalls—she has no memory of her arrival at Nantucket Cottage Hospital, where doctors quickly diagnosed her with an ascending aortic dissection, a condition that requires emergency surgery. And she definitely doesn’t remember the Coast Guard airlifting her directly to Massachusetts General Hospital.

Nantucket is roughly 100 miles from Boston, usually a quick flight. But on Friday, September 28, 2012, high winds and a storm made it too dangerous for the hospital’s MedEvac to transport Julie to Mass General. So the Coast Guard stepped in. “It was an awful night, they were the only people who could fly,” says Dr. Thor Sundt, chief of cardiac surgery at the Massachusetts General Hospital Corrigan Minehan Heart Center.

Dr. Sundt met Julie on arrival and escorted her directly to the operating room, bypassing the Emergency Department, thanks to technology. “I was able to look at the scan performed at the hospital on Nantucket and confirm that the diagnosis was correct,” says Sundt. “I felt comfortable admitting her directly to the OR.”

With a diagnosis like Julie’s, every second counts, and Dr. Wendy Macias-Konstantopoulos, the Emergency Department physician coordinating the calls from Nantucket, points to this collaboration as a major contributor to Julie’s successful treatment. “Without all these individuals communicating and collaborating, this patient may not have survived her ordeal,” she says.

An Integrated Approach to Care

Collaboration and communication top the list when it comes to meeting the multidisciplinary needs of patients, including Julie. “It’s not a trivial matter to have everybody on the same page,” says Dr. Sundt. “We’ve instituted a morning report in the Intensive Care Unit (ICU) where the key caregivers from last night and the key caregivers for the next day get together and talk about every patient in the unit, so there’s at least one point in the day where everyone has talked about every patient.”

The impact of this multidisciplinary approach reaches beyond the patient. “Every person—doctor or nurse—who came into my mother’s room knew what was happening with her care,” says Lisa Owens, Julie’s daughter. “And we really felt like we were part of the team.”

Julie stayed in the ICU for two weeks, and her care team was in constant communication with her family. Julie’s treatment wasn’t without complication—she needed multiple surgeries, and had an embolic stroke during surgery. But Lisa says the care team coordinated everything, and when it was time helped transition her mother to Spaulding Rehabilitation Hospital. “The doctors and nurses walked us through every decision and every complication,” she says. “They treated my mother like she was their own mother.”

A Full Recovery

Julie met Dr. Sundt for the first time—that she remembers—in the step-down unit. “He really wanted to give credit to the Coast Guard, he said he was walking around in his warm office and these guys came in from the cold,” she says. “But Dr. Sundt is my hero, he’s taken my life and made something new.”

Dr. Sundt feels differently. “The Coast Guard are the heroes in the story. They are the ones who risked their lives to save hers,” he says.

But there is one thing that everyone can agree on—Julie’s full recovery, “She’s a walking miracle, really,” says Lisa.

And that part, Julie remembers.

Learn more about our Thoracic Aortic Center

Back to Top