They established the Primary Percutaneous Coronary Intervention (PCI) program for ST-elevation myocardial Infarction (STEMI) in 2008. Drs. Gotsis and Silverman have been instrumental in implementing community-based programs for high quality heart care since they first joined Crystal Run in 1996 and 1999 respectively.
As seen in the Times Herald Record.
TOWN OF WALLKILL — There was no light when Kelly Krzyzak’s heart stopped. No tunnel, no out-of-body experience, no memories flickering in her mind’s projector. All was dark before Orange Regional Medical Center’s staff jolted her heart on their 40th try with their defibrillator paddles. But Krzyzak isn’t disappointed she didn’t see the light after her February 2015 heart attacks. She’s just grateful the hospital’s staff helped her wake to see sunlight again two weeks later. Orange Regional has its own reasons to celebrate lately. Healthgrades, a health-provider ranking and information service, has bestowed the hospital with three national honors for low heart-attack mortality rates and high-quality care. “I’m not really disappointed I didn’t see a light or anything, because I think I would’ve thought I was dead,” said Krzyzak, 47, of Bloomingburg. “It was amazing care. I’m so grateful to them. I’m not surprised they won these awards.” Healthgrades recently named Orange Regional one of America’s 100 Best Hospitals for Coronary Intervention following heart attacks, and bestowed a 2017 Coronary Excellence Award that places the medical center among the top 5 percent of heart-care hospitals nationally. For the third time since 2013, the hospital also received Healthgrades’ Five-Star rating for coronary intervention. That honor was the result of Orange Regional saving more lives than hospitals with similar patient volumes, by recording a 1.03 percent mortality rate versus the typical 2.67 percent. Healthgrades’ honors are derived from Medicare patient outcome data from 2013 through 2015.
Orange Regional’s numbers are so good that the Centers for Medicare & Medicaid Services’ most recent government rankings placed the medical center 35th out of 2,371 hospitals nationwide for risk-adjusted deaths among heart attack sufferers. The program performs roughly 3,000 cardiac procedures annually. The most serious 650 cases involve catheterizations to open blocked arteries with tubes, balloons and stents, while about 300 patients receive pacemakers and defibrillators. “It’s challenging to win these awards,” said Meadow Jaime, Healthgrades’ director of quality solutions. “They’re not something that are achieved by accident. They’re the result of purposeful interventions.”
Systematic approach
Orange Regional’s heart interventions begin with doctors who often teach and conduct research at medical schools, said Dr. William Gotsis, a Crystal Run Healthcare physician who helps lead the hospital’s catheterization and interventional cardiology departments. Treatment continues with sophisticated equipment like a rotablator drill for the calcified deposits that block arteries, and an Impella heart pump to sustain patients until transplants and bypasses. The care is assisted by nurses who never stop training, Gotsis added. “We’re not a small community hospital,” said Gotsis, who teaches at Albert Einstein College of Medicine in the Bronx. “The physicians and staff are experienced, the teaching and the advancement are constant, the equipment is top-notch, and our approach is integrated from emergency-room arrival to procedure performance and post-operative care.” Rosemary Baczewski, the hospital’s chief clinical officer, chalked up the awards to a mix of “clinical skill, expertise, teamwork, compassion,” and “a desire to go above and beyond.”
Back from the brink
Krzyzak experienced that desire firsthand when the hospital held a celebration for her survival a year after her heart attacks. Ironically, she first learned about Orange Regional’s heart care after she and a fellow preschool teacher, Diane Guttridge, were cutting paper hearts just before Valentine’s Day 2015 at Little Lambs Christian Nursery School in the Town of Crawford. Not long after Guttridge took her sick friend home, Krzyzak’s chest ached. She sweated and threw up as her husband, Donovan, called the ambulance that sped her to the hospital. The mother of three can barely remember being wheeled to the hospital’s catheterization lab while she proudly told a nurse about her daughter Ashlyn’s English studies at Siena College. That’s when darkness descended, as Krzyzak’s second heart attack began. She didn’t wake up again until two weeks later, as Mountainview United Methodist Church Pastor Robert Hewitt said the Lord’s Prayer beside her hospital bed. Dr. Apurva Motivala came within two attempts of stopping defibrillation when Krzyzak’s heart finally restarted. He implanted a heart pump to keep her alive before she was airlifted to Westchester Medical Center, where she eventually received a heart transplant. “Everybody thought that was going to be it for me, but then the people in the cath lab and Dr. Motivala saved my life,” Krzyzak said.