STEMI Systems Frequently Asked Questions

Updated:Aug 23,2013

How does Mission: Lifeline respond to the varied interests of competing hospitals and cardiology groups, multiple EMS providers, and access and control of critical care transport or helicopters regarding the STEMI plan?
Realizing that all of these entities come to the table with their own agendas, priorities and concerns, Mission: Lifeline seeks to build a consensus around what is best for the patient according to data, guidelines, resources and local leadership.

What are some common perceptions other parties within the STEMI system of care may have regarding STEMI-receiving hospitals that must be overcome in order to build more cohesive partnerships?
Emergency medical service (EMS) providers and STEMI-referring hospitals that treat patients who are then transferred to a STEMI-receiving hospital often face a “black hole” experience. Once the patient is out of their care, they are left with questions about outcomes and whether their contributions to treatment helped achieve success. To improve quality of care and recognize the contribution that EMS and STEMI-referring hospitals play in the treatment of STEMI patients, the PCI centers must close this communication gap.

Furthermore, STEMI-referring hospitals may feel that diverting or transferring STEMI patients to PCI-capable hospitals will result in substantial lost revenue. While STEMI victims make up the minority of heart attack patients, this perceived economic threat to non-PCI hospitals must be addressed.

What kind of measurement of performance and accountability at a systems level is needed?
Ongoing evaluation of any system of care is critical. For this reason, the American Heart Association dedicated an entire manuscript (published in Circulation) to the evaluation and outcomes of STEMI systems of care. The expert group that we have convened to oversee Mission: Lifeline will review the recommendations in the manuscript and prioritize the evaluation components necessary to measure the success and effectiveness of the initiative. Measurable patient outcomes and an evaluation mechanism to ensure quality-of-care measures reflect changes in evidence-based research, including consensus-based treatment guidelines, are two of our guiding principles.

What are Mission: Lifeline’s progress markers for regional STEMI systems?
Mission: Lifeline has defined progress markers for three key areas related to regional STEMI systems. These progress markers are determined through the various levels of Mission: Lifeline involvement. There are three levels of involvement with Mission: Lifeline: ParticipationRecognition and Certification. For every program, all system components (EMS, Non-PCI/STEMI Referring Centers and PCI/STEMI Receiving Centers) requirements must be met in order for the system to qualify for each level of involvement.