Cardiac care at the heart of Peconic Bay Medical Center’s 2017 ‘transformation’

The need for cardiac catheterization capabilities at Peconic Bay Medical Center was real and it was strong — that much hospital officials understood as they pressed the state health department to approve the establishment of the cardiac cath lab at the Riverhead hospital.

But precise data was hard to come by — it would require measuring the number of cardiac cases on the North Fork that bypassed the local emergency rooms at PBMC and Eastern Long island Hospital in Greenport and headed directly to Stony Brook University Hospital.

Nevertheless, PBMC officials persisted in their years-long quest to bring lifesaving interventional cardiac services to Riverhead. They looked at the geography of the East End, the aging population of the North Fork, and the urgency of delivering lifesaving advanced cardiac care within a narrow window of time and they pressed on. In fact, fulfilling this need was the driving factor in the hospital’s decision to merge with Northwell Health, which made a firm commitment to bring a cardiac cath lab to Riverhead as quickly as state regulators would approve it.

PBMC’s “transitional” cardiac cath lab — the permanent, larger facility is yet to be constructed as part of a $60 million building project now underway — opened on Monday, Oct. 16. Between Oct. 16 and Dec. 31, more than a dozen life-saving cardiac stenting procedures were done at the facility, according to hospital officials. That’s more than one emergency patient per week, right from the start. A total of 139 patients were treated in the cardiac center in that time.

Until Oct. 16, people having a heart attack caused by a blockage of a cardiac artery were either rushed by ambulance directly to Stony Brook or transferred from local hospitals to another hospital where stenting procedures could be performed — usually Stony Brook or Northwell’s Southside Hospital in Bay Shore.

“Time is muscle. Time is survival.” The longer the time between onset of symptoms and stenting, the more damage to the heart muscle – and the greater the risk of death. The American Heart Association practice guidelines say no more than 90 minutes should elapse before a cardiac patient with a blockage is undergoing the procedure.

There’s no way to know what the outcome would have been for those dozen emergency cardiac patients treated in the last 10 weeks of 2017 had the cardiac cath lab not been available in Riverhead.

“It’s going to save a lot of lives,” Wading River Fire Department Chief Kevin McQueeney said this month in an interview at department headquarters.

Cardiac care is just one piece of the puzzle from a public health standpoint, PBMC president and CEO Andrew Mitchell says.

The hospital last year attained provisional level-three trauma center status, allowing it to perform emergency trauma care services — for injuries such as those from car crashes and gunshot wounds — that previously required a long ride to Stony Brook.

The establishment of interventional cardiac care and the trauma center designation helped make 2017 a “milestone year in the hospital’s quest to become truly a regional medical center,” Mitchell said in an interview last week.

Last year was “transformational” in other ways, Mitchell said.

In July, the hospital broke ground on the $60 million, three-story critical care tower that will house the Kanas Regional Heart Center as well as an expanded emergency department, which will double the present size of the busy ER.

Also in 2017, Peconic Bay purchased the former Suffolk County National Bank headquarters on West Second Street and is moving non-clinical departments to the downtown office building. The relocations will allow the hospital to expand its inpatient capacity — something Mitchell said is much-needed, because the hospital is often at or near its current rated capacity of 140 beds.

The Second Street campus will likely also house ambulatory services in addition to administrative offices, Mitchell said.

“We’re undertaking a strategic planning process, looking at population growth and trends and the utilization of services in order to understand local needs and ‘outmigration’ for services,” Mitchell said, referring to people who leave the local region to obtain health care services.

PBMC successfully did that with orthopedic services, Mitchell said. Other specialties the hospital will develop — besides cardiac care — include cancer services, neurosciences, including neurosurgery, women’s health services, breast surgery and general surgery. Advanced cardiac care, such as open heart surgery, will likely be part of a five-year plan, Mitchell said.

Peconic Bay, with its $200 million annual operating budget, employs about 1,500 people, Mitchell said. It is the largest employer in the area. It was the fastest-growing hospital on Long Island for seven years in a row, he said.

PBMC became part of the North Shore-LIJ Health System in January 2016. (North Shore-LIJ subsequently changed its name to Northwell Health.)