HCGH/Sibley First High-Sensitivity Troponin Goes Live

Chest pain is the second most common complaint in the Emergency Department. When a patient is suspected of having a heart attack or heart muscle damage, a blood test is conducted to check for troponin.

On Tuesday, Nov. 1st, Howard County General Hospital and Sibley Memorial Hospital switched from using conventional cardiac troponin assays, (cTn) to the new “High Sensitivity” troponin T (Hs Tn-T) assay with great success! The T (Hs Tn-T) is the new, most up-to-date biomarker of choice to evaluate possible myocardial injury. Using this more sensitive assay allows clinicians to quickly, efficiently and accurately, diagnose an acute myocardial infarction.

The HCGH team led by Pathology Chair and Lab Medical Director Dr. Swetha Palaru, and Clinical Director, Tina Mancini-Flegel began building a program in January, along with the five Northern Hopkins hospitals, to develop an algorithm for diagnosis of patients. The team reviewed literature, shared lectures by the Massachusetts General ED champion, and studied information from other hospitals that went live previously.

The team consisted of providers from the ED, ICU, and cardiology, as well as hospital and nursing leadership. The HCGH nursing team created an educational slide deck in Health Stream and gathered documents and supplies needed, as collection tubes would be changed. The marketing department helped with printing/flyers and sending weekly emails. Drs. Michael Silverman, Don Berlin, Anirudh Sridharan, Patricia Pugh, Jay Menaker, Sanjivani Kolge and Eric Schwartz all contributed. When the first hs Trop T arrived in the HCGH lab at 3 a.m., everyone knew what to do and was well trained to handle the transition. The patient outcomes and ED length of stay at both HCGH and Sibley have lived up to the expectations of what this more sensitive test and shorter testing cycle would bring to the hospital. All 5 Northern Hopkins hospitals are expected to be live with the new high sensitivity test by the end of 2023.

Back Row: Dr. Michael Silverman, Dr. Donald Berlin, Dr. Anirudh Sriharan, Dr. Jay Menaker
Front Row: Pam Jarrar, Tina Mancini-Flegel, Dr. Swetha Paluru, Dr. Sanjivani Kolge, Dr. Patricia Pugh
3 a.m. – first hs Trop T arrives at HCGH