Opportunities to Improve STEMI Systems of Care

6 Universal Opportunities to Improve STEMI Systems of Care

Pre-Hospital Cath Lab Activation Protocols

911 EMS目的协议

Door In - Door Out at Referring Hospital

PCI协议传输

反馈回路

Sign and Symptom Onset to Seeking Medical Help

参与者和预期结果

机会	多学科团队成员 (可能包括其他团队成员)	想要的结果
Pre-Hospital Cath Lab Activation Protocols	EMS领导 EMS培训主任接收中心急诊医师心脏病专家接收中心急诊护理	Protocol developed and implemented that allows cath lab team activation to occur prior to EMS arrival with a confirmed STEMI patient EMS providers notify ED as early as possible of an incoming STEMI patient
911 EMS目的协议	911紧急调度 EMS领导 EMS医疗总监 EMS培训主任 STEMI Referring Hospital Representative	EMS providers transport the STEMI patient to the most appropriate hospital (even if located outside of the typical service area) EMS providers are empowered to by-pass the closest STEMI Referring hospital when EMS First Medical 联系 to PCI can be achieved in <90 Minutes or <120 Minutes when transport time is ≥45 Minutes
Door In - Door Out at STEMI Referring Hospitals for the STEMI patient transferring out for Primary PCI	Interfacility Transport EMS领导 (might be 911 EMS service) STEMI转诊医院急诊医师 STEMI转诊医院急诊护理 STEMI Receiving Center Outreach Coordinator	Primary STEMI reperfusion strategy plan in place Automatic acceptance plan in place with STEMI Receiving Centers Arrival to 12 Lead ECG ≤10 Minutes (walk in patient with cardiac chest pain) Primary detailed transfer plan in place Interfacility transport with emergent response Minimal time at bedside after Interfacility transport team arrival Recurrent STEMI Receiving Center outreach
PCI协议传输	Interfacility Transport EMS领导 (might be 911 EMS service) STEMI转诊医院急诊医师 STEMI转诊医院急诊护理 STEMI Receiving Center Outreach Coordinator	Primary and back-up transfer plans in place Automatic acceptance plan in place with STEMI Receiving Centers 一次呼叫STEMI警报过程
反馈回路	911 EMS领导设施间运输领导 EMS培训主任医疗急救人员 911紧急调度 STEMI Receiving Center Outreach Coordinator STEMI接收中心的急诊医生心脏病专家 STEMI咨询代表	Immediate feedback provided to EMS at ED bedside 24-48 feedback provided for every possible STEMI patient Multidisciplinary STEMI meetings include all participants, held monthly/quarterly and are collaborative All feedback forms look alike, no matter which hospital prepared them All feedback loop addressed - STEMI Receiving Center to EMS, 911 and Interfacility transport and to STEMI Referring hospital. STEMI Referring hospital to EMS, 911 and Interfacility transport. 911 EMS to 医疗急救人员 and dispatch
Sign and Symptom Onset to Seeking Medical Help	媒体幸存者把公共 STEMI Receiving Center Leadership and Outreach STEMI转介领导力 EMS领导	增加STEMI患者911的使用 Decrease the time from sign and symptom onset to the time medical attention is sought

Although the opportunities to improve STEMI Systems of Care and the desired outcomes are universal, each regional/local barrier identified requires local solutions capitalizing on or acquiring new local resources. The preferred implementation approach is through a multidisciplinary team approach identifying gaps in care, process improvement opportunities and potential solutions. Every STEMI System of Care is in constant flux and because of this, 个别特快专递机构, hospital and total system performance should be continuously monitored. Changes can and do occur – new laws are passed, EMS agencies and hospitals gain or lose resources, 新的领导层已经到位, 新的指导方针发布等等. 每一次改变都是一次新的机会. Each opportunity addressed = lives saved!

联系 (电子邮件保护) and get connected with your local AHA 使命:生命线 Quality Outcomes, Research and Analytics Director who can assist with:

STEMI Systems of Care Implementation Strategies
STEMI护理评估系统
遵循指南^®-冠状动脉疾病登记用于AMI数据收集
Participation in 使命:生命线 Regional Reports
遵循指南 - Coronary Artery Disease Super User Access
召集利益相关者
Quality, Process Improvement and Certification consultative services
使命:生命线^® 认可支援(医院及紧急医疗服务)

Written by 美国心脏协会 editorial staff and reviewed by science and medicine advisors.

请参阅我们的编辑政策和员工.

最后更新日期:2018年6月29日