A hospital is a bad place to have a heart attack. 

While cardiologists have made great strides speeding treatments to people who suffer a heart attack outside the hospital, scant attention has gone to patients already in the hospital for an unrelated medical problem who then have an attack. Recent studies suggest those patients are at least three times as likely to die before getting discharged as people who arrive at the emergency room after having a heart attack elsewhere.

Now, a group of 12 hospitals are joining forces to develop strategies—involving nurses in non-cardiac units to rapid-response teams in catheterization labs—to hasten care for those suffering in-hospital heart attacks. Researchers estimate some 10,000 people a year have an attack in the hospital while being treated for such illnesses as cancer or pneumonia or undergoing a surgical procedure such as a hip or knee transplant. That represents about 5% of the more than 200,000 people in the U.S. who suffer a major heart attack each year.

“With teams put together in a system, you can have better outcomes,” said Sidney Smith, a cardiologist at University of North Carolina at Chapel Hill who is spearheading the project. “We can save some lives.”

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