Mission: Lifeline STEMI ACCELERATOR Study: Developing Regional STEMI Systems of Care
“Shifting the focus from hospital (door) time to system (first medical contact) time identifies great opportunities to improve timely reperfusion,” according to the final results of the Mission: Lifeline™ STEMI AcceleratorStudy presented Nov. 19 during AHA 2014.
While it is known that timely reperfusion improves survival for ST-Elevation Myocardial Infarction (STEMI) patients, to date U.S. hospitals have really focused on improving individual hospital performance. In addition, while door to device times have improved, first-medical-contact to devices times and transfer times are suboptimal. This new study provides a closer look at how regionalization of STEMI care can impact outcomes.
The study, based on 484 hospitals and 1,253 EMS agencies in 16 regions, suggests that a nationwide systems of care implementation project can improve not only reperfusion time but survival. The primary outcomes were first medical contact to device time for direct presenters, first door to device times for transferred patients and the proportion at goal for all measures. All participants met quarterly data review requirements, participated in ongoing mentorship and executed set Mission: Lifeline protocols designed to help meet 2013 ACC/AHA guideline recommendations for the management of STEMI.
“Despite modest improvement in times to reperfusion, the improvement in survival suggests that programs to improve regional systems of care are important to improve public health,” study investigators said. They also noted that for patients transported by EMS, emergency department time is an important indicator of care coordination and survival.
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