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How the heart works: a detailed overview

How the Heart Works Diagram

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Public Health, Patient Safety, Heart Health

The human heart—about the size of one’s fist—provides oxygen and nutrient-rich blood throughout the body to sustain life. This powerhouse organ beats 100,000 times a day, pumping five or six quarts of blood each minute, or about 2,000 gallons per day. 

“In simplistic terms, the heart is a mechanical pump,” said Army Lt. Col. (Dr.) Eugene Soh, an  interventional cardiologist and assistant chief of cardiology at the Walter Reed National Military Medical Center in Bethesda, Maryland. “I equate it’s structure to be similar to that of a house; there are four ‘rooms’, and each chamber is separated from the other by a ‘door’—the doors are the four main valves of the heart. It has an electrical system and a ‘plumbing system’. The electrical system tells the heart when and how fast or slow to beat. It reacts to external stimuli, such as exercise or stress—which can cause one’s heartbeat to increase-- and will slow down when one is resting. The ‘plumbing system’ of the heart are the coronary arteries. They provide the blood supply to the heart.” 

The four chambers mentioned by Soh, are the two atria and two ventricles. The right atrium receives oxygen-poor blood from the body and pumps it to the right ventricle. The right ventricle pumps the oxygen-poor blood to the lungs. The left atrium receives oxygen-rich blood from the lungs and pumps it to the left ventricle. 

When it comes to heart disease, Soh talked about how the cause can be due to a number of factors. “You can have valvular disease, which can make the valves of the heart leak too much, or become too narrow, you can have electrical problems which can be due to a heart rate that’s too slow—and requires the use of a pacemaker—or having fast arrhythmias develop, which can be fatal in some cases. And then you have coronary disease, which is the most common form or heart disease. Heart disease is the number one killer of all Americans, more than all cancers combined.” 

With coronary heart disease, a waxy substance called plaque builds up inside the coronary arteries. When this plaque builds up in the arteries, the condition is called atherosclerosis. Over time, plaque can harden or break open. Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart, which can cause a heart attack. 

“The most common symptom of a heart attack is when someone is experiencing chest pain or discomfort,” said Soh. “In many cases, someone who is experiencing a heart attack may not be feeling a crushing pain. In fact, I’ve treated many patients in emergency rooms who have delayed coming in because they didn’t feel an ‘elephant on their chest’. So sometimes the symptoms can be subtle, like having shortness of breath or  nausea.”  Other associated symptoms may include breaking out into a sweat or having the pain radiate to the jaw, neck, or arm. 

Soh also went on to say that when it comes to providing first aid to someone who is experiencing a heart attack, the first thing you should do is call 9-1-1. “That is absolutely the first measure we should all take,” he said. “Not all heart attacks are immediately life-threatening, but they need to get to a monitored setting as quickly as possible. And certainly, don’t drive yourself [to the hospital] unless there are no other options.  An ambulance is definitely the best option.” 

To help prevent heart disease or heart attacks, Soh urges everyone to become engaged in some form of daily exercise. “The power of exercise is truly amazing,” said Soh. “Exercise has been shown to reduce the risk of heart disease and heart attacks. Eating healthy is also important.  I cannot stress enough how beneficial staying fit can be to one’s long-term health.”

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A decade of progress in Women’s health, cancer research

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10/26/2016
Navy Lt. Cmdr. Denise Thigpen, director, Breast Imaging Center at the Murtha Cancer Center at Walter Reed Bethesda, reads two mammograms of a patient. (Courtesy photo)

New discoveries at the Murtha Cancer Center have researchers encouraged about Women’s cancer research

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Hospital's sterile-processing techs are 'Gladiators' of patient safety

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9/14/2016
Army Staff Sgt. Oscar Domino (left), operating room technician, hands a sterile pack to Army Maj. Jerry Rivera-Santiago, sterile processing's officer in charge. Carl R. Darnall Army Medical Center's Sterile Processing Department assembles and packs more than 400 surgical units monthly. (U.S. Army photo by Gloria Montgomery)

Sterile-processing medical technicians are the multipliers of hospital safety who clean, disinfect and sterilize the hospital and dental clinic's surgical tools

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2016 DoD PSP Awards Application Guidance

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8/5/2016

This document provides guidelines for all interested parties who would like to submit an application package for the 2016 Advancement toward High Reliability in Healthcare Awards Program. The awards program recognizes those who have shown initiative and commitment to the development of systems and processes that will lead the MHS toward a better, safer, nationally recognized health care system that all MHS leaders and staff strive for each and every day and one that all patients deserve. Awards will identify efforts that progress the MHS on its journey of continuous improvement, in the areas of Patient Engagement, Healthcare Quality and Safety, and Improved Access.

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DoD PSP Treasure Chest: August Edition

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8/1/2016
Ensign Joshua Mondloch, a nurse assigned to Naval Medical Center San Diego, takes notes in the cardiology in-patient ward. More than 1,000 active duty and civilian nurses provide patient care throughout the medical center. (Photo by Mass Communication Specialist Second Class John O’Neill Herrera)

Welcome to the August edition of the DoD PSP Treasure Chest! Each and every month, we will be sharing resources to help you execute your day-to-day patient safety activities easily and effectively. Please visit us often and get access to tools and information developed with you, our committed MHS patient safety champions, in mind! This month we highlight the following resources: Patient Activation Resource Guide, Ask Me 3® Brochure, On-Demand e-Learning Courses, and Facebook Page.

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Patient Safety in Action: The I’M SAFE TeamSTEPPS® Checklist – An Exercise in Openness and Transparency with your Team

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8/1/2016
NEWPORT NEWS, Va. (Apr. 14, 2016) -- During a General Quarters training exercise, Sailors assigned to Pre-Commissioning Unit Gerald R. Ford's (CVN 78) medical response team, simulates care and treatment for common injuries. This ship-wide general quarters drill focused on damage control and emergency responses and is a significant step in certifying the crew as they train to fight and take delivery of the ship.(U.S. Navy photo taken by Mass Communication Specialist 3rd Class Matthew R. Fairchild/Released)

The connection between transparency and high reliability is one that touches many aspects of what we do as MHS patient safety professionals. We strive to be transparent in the way we share information with our patients – working with them as partners in their care and informing them of what we do openly and visibly. We are also transparent about our MTFs progress towards high reliability so that we can continue marching towards our goal of zero patient harm with efforts such as the Patient Safety Culture Survey. Another way that we, as MHS patient safety professionals, can display transparency on a daily basis is by using tools such as the I’M SAFE TeamSTEPPS Checklist.

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HRO Corner: The Patient Safety Culture Survey Resource Guide – An Overview

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8/1/2016
Soldiers from the 399th Combat Support Hospital, 804th Medical Brigade, 3d Medical Command (Deployment Support) watch video footage of their performance during an exercise held April 2, 2016 at the Mayo Clinic Multidisciplinary Simulation Center in Rochester, Minnesota. The unit's every move was recorded at the facility, which allowed them to review and improve their performance throughout the course of the exercise. During the exercise, the unit, which is based out of Fort Devens, Massachusetts, practiced the Team Strategies and Tools for Enhanced Performance and Patient Safety, or TeamSTEPPS, model of patient care. TeamSTEPPS is a framework implemented by the Department of Defense to optimize performance of military medical teams and reduce communication errors that can result in improper patient care. (Photo by: Staff Sgt. Andrea Merritt)

The DoD is on a journey to transform the Military Health System (MHS) into a high reliability organization (HRO) to ensure safe, reliable care for all of its patients and their families. This transformative shift is one that requires a laser-sharp focus by every one of us – leadership and frontline staff – to identify high-risk situations before they lead to an adverse event. To make this possible, prevention and performance improvement must become intrinsic elements of what we do on a daily basis. First, however, we must understand the progress each of our Military Treatment Facilities (MTFs) is making towards the high reliability goal.

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MHS Patient Safety Spotlight

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8/1/2016
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The MHS Patient Safety Spotlight is a new resource designed to highlight best practices and interesting initiatives that come from the field and are worthy of being shared across the enterprise. This resource features data-driven examples of improvement and case studies that tackle specific problems with specific solutions.

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Feature: Transparency, High Reliability and Patient Safety

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Senior Airman Wesley Hong, 60th Medical Diagnostics and Therapeutics Squadron picture archiving communication system administrator, reviews patient imagery May 25, 2016, at David Grant USAF Medical Center at Travis Air Force Base, Calif. Hong works in the hospital's PACS department, which is the largest in the U.S. Air Force. The department is responsible for ensuring the accuracy of health records for medical facilities at 19 bases, including clinics in Afghanistan. (U.S. Air Force photo by Tech. Sgt. James Hodgman)

On any given day, Military Health System (MHS) patient safety professionals are working tirelessly to ensure they provide the highest quality of care to their patients. Driven by a high level of dedication, MHS patient safety professionals know that our patients are the single most important part of our mission and we must serve our patients in an open and transparent way.

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MHS Patient Safety Data Snapshot

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The new MHS Patient Safety Data Snapshot is a monthly compilation of two types of patient safety data 1) Sentinel Event (SE) notifications submitted to the Patient Safety Analysis Center (PSAC); 2) Anonymous, voluntarily reported patient safety events via the web-based incident reporting system known as PSR.

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Texas Guardsmen contribute to medical relief effort

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7/22/2016
U.S. Air Force Capt. Brett Ringger, optometrist , 136th Medical Group, Texas Air National Guard, examines a patient  during the Greater Chenango Cares Innovative Readiness Training in Cortland, New York. The IRT provided medical care to patients at no cost, as well as eye examinations and glasses on site. (U.S. Air Force photo by Senior Master Sgt. Elizabeth Gilbert)

The joint training exercise allows for service members to practice their skills in preparation for wartime operations while also providing a needed service to underserved communities

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An Army specialist helps create a possible Zika vaccine

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U.S. Army Spc. Chris Springer flashes a smile as he puts some of his work into one of the facility’s many refrigerators. (DoD photo by Katie Lange)

An Army specialist is one of very few service members to get to work on the Zika vaccine

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Army public health promotes free tick-testing program

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The Army Public Health Center provides a tick identification and testing service for DoD health clinics in the continental United States

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MHS Leadership Engagement Toolkit

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The Leadership Engagement Toolkit was designed to help healthcare leaders assess gaps in their safety culture, engage key influencers for change, set goals for targeted improvement, implement proven safe practices, and reinforce key behaviors to ensure high-reliability performance for improvement. There are two sets of evidence-based best practices (“strategies”): Executive Leadership and Frontline Physician Leadership. The practices focus on what the practice is, why it is used, and how to implement it. There is also a "How to Guide" that focuses on getting started, equipping leaders as coaches, and making and measuring progress.

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Army researchers, Sanofi Pasteur to co-develop Zika virus vaccine

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A digitally-colorized transmission electron micrograph of Zika virus, which is a member of the family Flaviviridae. Virus particles, here colored blue, are 40 nanometers in diameter with an outer envelope and an inner dense core.

A recently signed cooperative research and development agreement will allow the transfer of the Zika purified inactivated virus, or ZPIV, technology to Sanofi to explore advanced and larger-scale manufacturing and production

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USU students learn public health, zombie style

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An animated zombie pandemic scenario helps students in the family nurse practitioner doctorate of nursing practice program at the Uniformed Services University of the Health Sciences to understand key principles in responding to and understanding population health – the overall health of a group, be it a group of employees, a community, or entire nation. USHS graphic

An animated zombie pandemic scenario helps students in the family nurse practitioner doctorate of nursing practice program at the Uniformed Services University of the Health Sciences to understand key principles in responding to and understanding population health.

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