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ECMO team to help other providers create their own programs

Mar. 12, 2020, 9:27 AM

 

by Matt Batcheldor

Vanderbilt University Medical Center has signed an agreement with Ballad Health, a regional health system serving East Tennessee and Southwest Virginia, to train its team to provide a life-saving medical program called ECMO.

ECMO, or extracorporeal membrane oxygenation, is a life-sustaining mechanical system that temporarily takes over for the heart and lungs of critically ill patients, allowing them to rest and recover.

Operating an ECMO program requires a high level of expertise, and this is the first time that VUMC has franchised its institutional knowledge in such a fashion, said Ashish Shah, MD, professor and chair of Cardiac Surgery.

“Our agreement with Ballad health allows us to bring the quality, experience and best practices of Vanderbilt’s Extracorporeal Life Support (ECLS) program to another large region,” Shah said.

“Frankly, there is no reason for programs to reinvent the wheel and this can mean the difference between life and death in the most critical patients.”

Operating for more than 25 years, VUMC’s ECMO program is the first and largest in Middle Tennessee and one of the largest in the nation, serving more than 100 patients per year.

The ECMO machine’s external pumps and oxygenators remove carbon dioxide from the blood, replace it with life-saving oxygen and then return it to the patient’s circulatory system.

Ballad Health’s ECMO program is beginning to treat adult patients at its Johnson City (Tennessee) Medical Center, a five-hour drive from Nashville. VUMC has been offering ECMO care to such patients, but they face hours in a ground ambulance or Vanderbilt LifeFlight’s fixed-wing plane or helicopter in certain conditions.

Now patients can be stabilized in Johnson City and either treated there or transported to Vanderbilt if they require more complex care.

The agreement allows Ballad’s patients to have access to Vanderbilt’s health system, while allowing them continuity of care when they return to their local providers.

“We are hoping this will allow us to better initiate and provide ECMO services to patients from East Tennessee who need these services, said Todd Rice, MD, MSCI, associate professor of Medicine and director of the Medical Intensive Care Unit (MICU).

“To be able to have the access to this level of care in their own backyard is hugely beneficial for the patients in that region,” said Lynne Craig, RN, ECMO coordinator, who is helping to teach Ballad Health’s team of pulmonologists, intensivists, nurses and respiratory therapists how to care for ECMO patients at the bedside.

“We put them through a provider course where they get a background of what ECMO is, where it came from, where it’s going and how we move forward from our management standpoint,” she said. “Following that, I will actually go to Johnson City and help teach all of their staff from a bedside patient perspective — what they look like, safety and the things that are involved.”

When Ballad Health patients are transported to Vanderbilt, their local physicians can use an Epic interface to monitor patients, examine labs and recommend care in collaboration with VUMC physicians. Ballad Health also gains access to VUMC’s quality meetings — debriefing on patient care, measuring outcomes and working to improve them.

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