Spotlight on a PERT:
Hello again from the Communications Committee!
We are excited to continue our Spotlight on a PERT series with a focus on Ellis Hospital, a part of the Ellis Health system, in Schenectady, NY.
Each month we send a set of questions to a different PERT from around the country to get a sense of how they handle pulmonary embolism at their institution. This mini-interview, this month with Dr. Saddam Abisse, is then shared with the whole Consortium to help new PERTs get started and give experienced groups a “behind the scenes” look to see how others work.
Please let us know if you’d like to be next (or if you have other ideas for questions)!
Saddam Abisse, MD
Key members in their PERT include:
Cardiology: Saddam Abisse, Christopher Dibble, Stephen Piacentine
Emergency Medicine: Joanne McDonough
Interventional Cardiology: Satish Madiraju, Steven Weitz, Peter Cospito, Robert Parkes
Pulmonary and Critical Care: Ahmed Khan, Alec Platt, Myril Vitrysal
Cardiothoracic Surgery: Herbert Reich, Kyril Choumarov
How long has your institution had a PERT?
The PERT program at Ellis hospital started in November 2015 with our first Pharmaco-Mechanical Thrombolysis performed in a young gentleman with saddle PE after orthopedic surgery. Our team comprises representatives from the Emergency Department, Non-invasive Cardiology, Interventional Cardiology, Pulmonary & Critical Care Medicine and Cardiothoracic surgery. We joined the PERT consortium in the summer of 2016.
Who participates on the PERT team?
The main participants in the PERT team are Pulmonary & Critical Care, Emergency Medicine, Non-invasive Cardiology, Interventional Cardiology and Cardiothoracic Surgery. Hematology is also involved when necessary in circumstances where hypercoagulability is suspected.
How is the team activated?
The Pulmonary embolism response team is activated via paging operator for “PERT” consult. The first responders to the page are Pulmonary & Critical Care Medicine and Cardiovascular Medicine. Interventional Cardiology and Cardiothoracic surgery are consulted via the Misecure internal text messaging system to discuss appropriateness and suitability for various interventional therapies.
How does the team communicate?
The team mainly communicates via phone call and Misecure text messaging. We also have access to remote imaging systems off site. For complicated cases we have live teleconferences or meet in person as a team to review data and discuss the management plan.
What improvements have you seen in patient care with the introduction of the PERT concept?
With increased awareness about risk factors and symptoms for pulmonary embolism and our PERT program, we have noticed greater recognition and faster time to diagnoses of pulmonary embolism. We also now have a more standardized and streamlined treatment protocol for pulmonary embolism.
How do you see your team evolving in the future?
I see our program becoming a leader in treatment of all Venous Thromembolism and intra-cardiac thrombus in the region. We have performed 30 EKOS cases, 2 Angiovac, 4 PENUMBRA thrombectomies and 1 ECMO case for management of VTE. We are currently participating in the Angiovac registry. We have created our own internal database to track outcomes and our goal is to participate in other data registries that are on the horizon such as PERT and Penumbra.
What advice would you give to a new hospital looking to start a PERT?
We advise building a protocol for treatment of the disease and then bring all the stakeholders to the table. This can be challenging in a private practice and community hospital setting. In our program, we had many monthly meetings with all stake holders, including physicians, administrators, IT and pharmacy. Also expect that not all physicians/providers will agree with or accept the team concept and/or new interventional treatments of pulmonary embolism. Nonetheless, as long as the patient’s best interest is the main concern of the program, you will have a very productive and successful program.