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Upstate receives national certification for life-saving heart and lung treatment program

Upstate Medical University is now only the second hospital in the country to earn one of the nation’s top certifications for its Extracorporeal Life Support program (ECLS).

The certification, from DNV GL Healthcare, the nation’s fastest growing accreditation organization, means that Upstate’s life-saving program meets more than 50 standards and operates at the highest levels of coordination between interdisciplinary teams.  

ECLS is the use of external machines to provide prolonged cardiac and respiratory support to patients whose heart and lungs are not able to function. The ECLS or ECMO (Extracorporeal Membrane Oxygenation) machine handles oxygen delivery to the patient’s body, allowing a person’s lungs and heart to rest and heal. Patients can rely on an ECLS machine for a few hours or weeks at a time. 

“This is a testament to our program and the hard work of so many,” said Christopher Tanski, MD, medical director of Upstate’s ECLS program. “The coordinators, the specialists, and many others, have worked hard over the last five years to develop a major program.”

Most hospitals offer ECLS but not all have full programs and infrastructure to support their use. Upstate has done ECLS for years but it wasn’t until 2017 when Tanski decided to expand individual usage of the machines into a fully supported program. Before that, Upstate could put patients on ECLS, but then those patients most often had to get transferred to other hospitals to complete their treatment. Patients on ECLS need 24-hour monitoring by a specialist.

“We could put patients on ECLS, but we couldn't really manage them,” he said. “That was frustrating to me. They would get sent to other places and that’s not good for families or patients to have to go to New York City or Rochester.”

Now most of the patients in the ECLS program stay at Upstate for the duration of their treatment. From 2017 through 2021, Upstate has treated more than 100 patients with ECLS, including 22 so far with Covid-19. Patients who need ECLS support for either their heart or lungs or both are often the sickest in the hospital. The hospital has seven ECLS machines and can have patients on four of them simultaneously, including pediatric patients

Tanski said Upstate was one of the first hospitals to develop a set of credentials required to become a specialist in the program. Upstate incorporated training and a credentialing committee, At the time he said this was unheard of. Since then, many other hospitals have reached out to Upstate to develop their own credentialing.

In 2020, a team from Upstate completed work with ECLS experts across the country to develop an exam to award an official ECLS Specialist certification from the American Society of Extracorporeal Technology. The certification exam creation process was published in  The Journal of ExtraCorporeal Technology. The 100-question test covers more than 700 skills, abilities, and knowledge points. 

To earn the DNV certification, Upstate had to meet more than 50 standards covering program quality, program and staffing management, infection control, program service delivery and multidisciplinary approach. Tanski said that while the process was a lot of work, Upstate was already incorporating most of the measures in the standards, since it has such a robust program,. The process was completed with a two-day survey of staff, equipment, and procedures by DNV.

“We know how to take care of these patients, we know how to optimize their chances of recovery,” Tanski said. “We have all the ancillary services in place that are hallmarks of a successful ECLS program with the best outcomes.”

The process offered an opportunity for improvements that will make the program that much stronger

“At Upstate, we have worked hard to strengthen our ECLS program to enhance the patient experience,” said Asim Sharif, DBA, RRT-NPS, ECLS coordinator. “Our ECLS program follows the mission of SUNY Upstate Medical University, which is to improve the health of the communities we serve through education, biomedical research, and patient care. The accreditation certificate is associated with our better performance in patient care. It strengthens our efforts to enhance our patient safety and quality care and shows Upstate's commitment to continuous improvement.”

 Caption: Christopher Tanski, MD, medical director of Upstate’s ECLS program, with an ECMO (Extracorporeal Membrane Oxygenation) machine.