STEMI SYSTEMS OF CARE STEMI Systems of Care

STEMI SYSTEMS OF CARE STEMI Systems of Care: Update on Mission: Lifeline Alice K. Jacobs, M. D. Boston University Medical Center Boston, MA

Alice K. Jacobs, MD § Grants/Contracted Research – Abiomed, Inc. – Accumetrics, Inc. – Abbott Vascular

STEMI SYSTEMS OF CARE Disclosure Information FINANCIAL DISCLOSURE: Research Support: Abbott Vascular, Abiomed, Accumetrics UNLABELED/UNAPPROVED USES DISCLOSURE: None

STEMI SYSTEMS OF CARE • Community-based National initiative • Improve quality of care + outcomes in STEMI • Improve healthcare system readiness and response to STEMI

STEMI SYSTEMS OF CARE • May 30, 2007 Conference Proceedings published in Circulation and Mission: Lifeline Launched

STEMI SYSTEMS OF CARE Developing Systems of Care for STEMI

STEMI SYSTEMS OF CARE Status Report: February 2011 x EMS System Assessment and Improvement x Evaluate Existing Models q Establish Local Initiatives q Explore Possibility of National STEMI Certification

STEMI SYSTEMS OF CARE EMS System Survey

STEMI SYSTEMS OF CARE Response Rates • Responses Overall: N=5415 • By Region of the US –Northeast: 26% –Midwest: 36% –South: 26% –West: 12%

STEMI SYSTEMS OF CARE Pre-hospital 12 -Lead ECG Percentage of Vehicles with 12 Lead ECG devices Responders Trained to Interpret 12 -Lead ECG for STEMI

STEMI SYSTEMS OF CARE Destination Protocol for Pre-hospital Identification of STEMI Patients All Respondents Serving a Rural County

STEMI SYSTEMS OF CARE Have You Registered Your STEMI System with Mission: Lifeline?

STEMI SYSTEMS OF CARE

STEMI SYSTEMS OF CARE

STEMI SYSTEMS OF CARE Mission: Lifeline Social Networking Community http: //mlcommunity. heart. org 15

STEMI SYSTEMS OF CARE Establishing Local Initiatives Task force members: • Patients and care givers • Physicians, nurses and other providers • Payers • EMS • PCI capable and non-PCI capable hospitals • Department of Health • Rural health association • Quality improvement organizations • State and local policymakers

STEMI SYSTEMS OF CARE Role of Public Policy in the Development of STEMI Systems of Care ü 2011 AHA State Legislative/Regulatory Priority AHA Model Legislation: HEart Attack Response and Treatment Act (HEART Act)

STEMI SYSTEMS OF CARE AHA Model Legislation: HEart Attack Response and Treatment Act (HEART Act) Section 3. A Statewide System for Heart Attack Response and Treatment • Must be consistent with ACC/AHA guidelines • Must have a community perspective • Components • Hospital • Classification • EMS • Equipment and training • Transport and transfer • Continuous quality improvement • Data collection and analysis • ACTION Registry – Get With The Guidelines

STEMI SYSTEMS OF CARE National STEMI Certification Program • The American Heart Association has developed recommendations for a STEMI participation, recognition, and certification program for the system and each system component (STEMI Referral and Receiving Centers, EMS System Certification) Criteria posted on website: www. americanheart. org/missionlifeline

STEMI SYSTEMS OF CARE Active Sites = 621 WA (9) VT (0) ND (1) MT (2) OR (10) MI WY (0) UT (2) CA (40) AZ (5) CO (13) NY (21) WI (9) MI (11) IA (6) NE (6) NV (7) NH (1) MN (6) SD (3) ID (2) ME (1) IL (38) KS (10) OK (7) NM (3) OH (33) AL (12) CT (7) NJ (8) VA (17) MD (23) DC (1) NC (27) TN (20) AR (2) RI (2) DE (1) WV (1) KY (5) MO (21) MS (12) TX (77) IN (19) PA (29) MA (7) SC (15) GA (14) LA (9) FL (36) AK (1) PR(2) HI (4) Last updated: 9/22/2010

STEMI SYSTEMS OF CARE Mission: Lifeline Reports 21

STEMI SYSTEMS OF CARE Mission: Lifeline Recognized Hospitals As of September 2010, Ø 5 STEMI-Receiving hospitals have received a Silver Award Ø 72 STEMI-Receiving hospitals have received a Bronze Award 22

STEMI SYSTEMS OF CARE Mission: Lifeline Recognized Hospitals These hospitals were recognized at AHA Sessions 2010 and were recognized in the August 2010 Mission: Lifeline US News and World Report Ad. 23

STEMI SYSTEMS OF CARE

STEMI SYSTEMS OF CARE Priorities for 2011 • Increase hospital and EMS and system participation • Increase use of ARG, and enhanced ARG capabilities • Increase number of hospitals with recognition • Progress on certification • Assessment of impact of Mission: Lifeline • Focus on patient and public initiatives