STEMI Referring Hospital Frequently Asked Questions

Updated:Aug 23,2013

Is bringing timely percutaneous coronary intervention (PCI) a realistic goal for all STEMI patients in this country?
PCI, when administered within the 90-minute door-to-balloon window, is the preferred method of treatment. However, because of geographical barriers, inclement weather, patient hesitation in seeking help or other delays, it’s not always possible. The longer it takes to administer PCI to a patient, the less beneficial that treatment is compared with timely administration of clot-busting pharmaceuticals. Timely lytics are better than delayed PCI, and all patients deserve quick reperfusion of some sort. Therefore, non-PCI hospitals will always be key STEMI portals across the nation. Optimizing care at STEMI-referring hospitals should be a priority in STEMI improvement efforts, not just an afterthought.

When EMS circumvents the nearby STEMI referring hospital to transport a STEMI patient directly to a PCI-capable hospital, won’t the STEMI referring hospital encounter significant financial loss?
STEMI-referring hospital administrators may see Mission: Lifeline as a threat to their revenue generation. However, it’s important to keep in mind that the majority of heart attack patients suffer non-STEMI events, so farther transport to a PCI hospital is not necessary or recommended. This fact limits the financial impact on STEMI-referring hospitals.

How do STEMI referring hospitals overcome the frustration of not knowing what happens to a patient who is transferred from their care to a PCI-capable center?
Mission: Lifeline seeks to improve communication between all parties involved in a STEMI system of care. Currently, emergency medical services organizations and STEMI referring hospitals are often left with questions about the outcome of STEMI patients once they are transferred out of their care. As recommended by the Mission: Lifeline initiative, follow-up data will be provided to all parties who were involved in administering care to a patient prior to transfer. By closing the communication loop, the various entities in the STEMI system will be informed of patient outcomes, and this data will be valuable in helping them gauge success and determine action items to improve the quality of care.