New hospital unit may have saved man from heart attack

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KANSAS CITY, Mo. -- Jake Winship is an actuary who analyzes risk for insurers.  One day in August, Jake measured his own risk when he had chest and jaw pain.  He figured there was an 80 percent chance it was indigestion.

"But I thought the 20 percent chance that it was something significant was probably worth going in," said Winship.

He went to the emergency room at Saint Luke's Hospital even though the pain had stopped. Blood tests showed no heart attack, but the doctor was still concerned.

"I don't feel super comfortable sending you home. I don't really know if you need to be admitted," said Dr. Blair Cote, an emergency physician.

She had a new option for Winship. He was taken to the clinical decision unit, an observation unit.

"It can answer these questions or give these treatments in a very efficient and time-effective manner," said Dr. Cote.

The doctor says that's compared to being in a regular hospital unit or going home from the e.r. with instructions to follow-up with your doctor. Before the unit existed?

"We'd turn the onus back on them to try to make a phone call and get plugged into the health care system. So sometimes these patients could be lost for follow-up," said Dr. Marc Larsen, the medical director of emergency services.

Winship says he probably wouldn't have followed up very soon if he'd been sent home. By being in the unit, he got a heart stress test within a few hours. It indicated trouble, so the next day, he had an angiogram which showed a 70 percent blockage in one heart artery. The artery was unblocked and a stent was placed in it.

"That's saving someone from a possible life-threatening heart attack," said Dr. Cote.

Winship added, "I feel very fortunate."

He's glad he went to the E.R. and that he was moved to the clinical decision unit.

Observation has become a bad word for many insured patients. That's because they have higher out-of-pocket costs when they're under observation in the hospital instead of being admitted. But Dr. Cote claims that having this unit should result in cost savings since patients are typically there for 10 to 15 hours instead of several days if they're played under observation on a regular hospital floor.

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