Mission: Lifeline The AHA STEMI Initiative Status Report Alice K. Jacobs, M.D. Boston University Medical Center Boston, MA There are no conflicts or relationships to disclose. AHA’s STEMI Initiative Mission: Lifeline. Community-based National initiative
The AHA STEMI Initiative
Alice K. Jacobs, M.D.
Boston University Medical Center
There are no conflicts or relationships to disclose.
How do we increase the number of patients with timely access to primary PCI?
Distribution of Total Door-to-Balloon Time in Transfer Patients in NCDR 2005-06
Median D-to-B 152 min
< 90 min = 8.6%
1 to <2
3 to <4
5 to <6
4 to <5
6 to <7
2 to <3
Chakrabarti. JACC. 2008;51:2442-2443.
Administrative Structure Patients in NCDR 2005-06
Elliott Antman, MD
Bob O’Conner, MD
Gray Ellrodt, MD
Bob Harrington, MD
George Mensah, MD
Eric Peterson, MD
David Williams, MD
State Health Alliances
Cultural Health Initiatives
EMS System Assessment and Improvement Patients in NCDR 2005-06
Designed for all EMS County organizations Patients in NCDR 2005-06
TEST Phase from May 12 through June 6, 2008 distributed by State Health Alliance staff in eight test states: CA, DE, KS, MO, NC, PA, TX, and WY
After test phase, the assessment was distributed to all fifty states via NASEMSO and other EMS organizations.EMS Assessment for STEMI
Evaluate Existing Models Patients in NCDR 2005-06
Have You Registered Your STEMI System with Mission: Lifeline??
- Administration - Locale (Urban, Rural) - Processes of Care - Financial Considerations - Disparities in care
- Resource allocation
Establishing Local Initiatives Lifeline?
convened the task force initiative at the
state and local levels to identify ways
to implement national recommendations for STEMI systems in local communities.
Patients and care givers Lifeline?
Physicians, nurses and other providers
PCI capable and non-PCI capable hospitals
Department of Health
Rural health association
Quality improvement organizations
State and local policymakersEstablishing Local Initiatives
Task force members:
Consider integrated payment
No penalty to patients
9-1-1 interhospital transport
SYSTEM OF CARE
CENTER OF CARE
Treatment protocols and clinical pathways
CENTER OF CARE
Protocols and toolkits
STEMI Center Certification
Quality improvement measures
Jacobs. Circulation 2007;116:217-230.
Not PCI Lifeline?
American Ambulance Assn
Society of Chest Pain Centers
Center of Care
Adapted from Jacobs. Circulation2007;116;217-230