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Covenant Health leads new, advanced heart care “Shock Initiative”

KNOXVILLE -- Three area Covenant Health hospitals have joined other community health care providers in a new “Shock Initiative”. The initiative is aimed at treating heart attack patients that incorporates a newly developed shock algorithm which improves survival. Participating hospitals are Fort Sanders Regional Medical Center and Parkwest Medical Center in Knoxville and Methodist Medical Center in Oak Ridge.

The three facilities are all a part of Covenant Health, which represents the largest participating health system in the collaborative. Other partners include other local healthcare providers, as well as health systems from six other cities across the United States.

In cardiogenic shock a patient’s heart function drops dramatically, leading to low blood pressure and decreased blood flow to vital organs. Traditionally, physicians have had to rely on slower-acting medications and less effective mechanical devices to keep the heart functioning, but often the circulation of blood flow is not enough to keep the vital organs working properly. This has historically led to a 50 percent chance of death when cardiogenic shock occurs.

With the advent of the shock initiative, survival rates have improved to almost 80 percent. The protocol uses a device known as the Impella, which is a small pump that alleviates the work of the heart during a heart attack. Additionally, the protocol incorporates a novel algorithm which allows doctors and nurses to systematically wean off the medications that can worsen outcomes in patients with shock. This collaboration and data sharing allows the ability to standardize the delivery of care in for a high-risk population of patients.

Lead Covenant Health cardiologists pioneering the initiative include Todd Justice, MD, Methodist Medical Center; Ayaz Rahman, MD, Parkwest Medical Center; and Joshua Todd, MD, Fort Sanders Regional Medical Center.

“Our cardiac team at Covenant Health is very excited to collaborate with local health systems in an effort to improve outcomes in patients with cardiogenic shock,” Dr. Rahman said. “We know that shock complicating a heart attack is a lethal disease. This opportunity will allow us to unite with national thought leaders in order to deliver the highest and most technologically advanced cardiac care to our community.”

“I am excited that we have a technology that can improve the odds of survival for these patients,” Dr. Justice added. “We have used the Impella support device at Methodist for several years now, and I can say unequivocally that I have had some patients who left the hospital in a vertical position because of it.”

“This initiative is an opportunity for Knoxville cardiac providers to work together and improve treatment options for patients admitted with cardiogenic shock,” Dr. Todd said. “We have been using this protocol, which has demonstrated a marked improvement in survival for a very sick group of patients at Fort Sanders Regional, and by joining the national initiative, Covenant Health and other Knoxville health systems will benefit from shared data and best practices.”

As the initiative continues, data regarding efficacy and patient outcomes will be shared among the participating health systems and released publicly.

Mike Belbeck, Covenant Health executive vice president of operations, said the health system is “pleased to be part of such an exciting initiative that can have such a positive impact in the lives of critically ill patients in the communities we serve.”

Covenant Health is a community-owned health system providing comprehensive health services throughout Tennessee. Headquartered in Knoxville, Covenant Health includes 10 hospitals as well as numerous outpatient services and clinics. The health system also includes specialty providers of behavioral, oncology, and rehabilitation services, along with home care, physician clinics, and community wellness and outreach programs. The area’s largest employer, Covenant Health has more than 10,000 employees, affiliated physicians and volunteers who serve more than a million patients annually. Covenant Health has received regional and national recognition for quality and patient satisfaction, and has been named by Forbes as one of America’s Best Employers for two years in a row. For more information visit

Published February 23, 2018

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