The Global Heart Attack Treatment Initiative (GHATI)

The Global Heart Attack Treatment Initiative (GHATI) is dedicated to collaborating, collecting and sharing data, and utilizing tools to improve acute myocardial infarction (AMI) care for your MI patients. This international quality improvement program welcomes institutions with patients who present and are treated for MI with a focus on institutions in low- and middle- income countries.



Interested Sites

Here are some of the most frequently asked questions about joining GHATI. The GHATI Brochure provides additional details and information about joining GHATI.

  1. What are the benefits of participating in the GHATI program? There are many! Below are just a few of the many benefits one can expect:
    1. Facilitated data collection on site.
    2. Quarterly reports on quality metrics and data points in the inpatient setting.
    3. Opportunity to establish benchmarks, assess variation in performance and identify gaps in care.
    4. Access to expert support and QI toolkits.
    5. Improvement in STEMI care to MI patients.
    6. Collaboration and knowledge-sharing with other CV care providers.
  2. Is there a fee to participate in GHATI? No, there is no fee to participate in GHATI. GHATI requires time, resources, and internal organizational support at the participating facility.
  3. Do sites report patient health information? No, all patient health is omitted when reporting. Aggregated data (mean, median, percentage) are shared with the ACC.
  4. Is my site information shared? All site-specific information is blinded, and site anonymity is maintained on all reports.
  5. My facility is not in a LMIC, can I still participate? Yes! Participation from diverse care settings is crucial to building an invaluable data set that will advance the development and delivery of STEMI standards of care.
  6. Can the Clinical Champion and Administrative Champion be the same person? No. There must be two individuals involved with GHATI at each facility. This ensures that every site has two people capable of maintaining the program in case of staff changes.
  7. Can GHATI establish a country program? If a country wishes to sign up various sites, GHATI can work with a country coordinator to facilitate the onboarding of each interested institution. However, the program does require that each facility complete an application, sign its own contract, supply their own Site Champions, and submit their data independently. Because GHATI maintains site anonymity throughout the entire process, data and reports from each site will not be shared with the country coordinators or anyone besides the selected Site Champions.
  8. Is there flexibility to the number of patients reported? Ideally sites submit aggregated numbers based on all patients to ensure that reports are representative of what sites are seeing on a quarterly basis. We do understand, however, that sometimes sites are unable to report on all patients due to varying limitations of data collection on site, and therefore we ask that sites report on a minimum of 20 consecutive patients if required. If your site does not see 20 STEMI patients a quarter but you are still interested in participating, contact us at GHATI@acc.org directly.
  9. Does GHATI offer sites financial support to facilitate data collection? GHATI does not currently offer financial support to participating sites. We are, however, looking for options to provide this in the future to site's that require it.

Applying for GHATI is easy! It takes a few minutes to complete the form with the requested information. Make sure to have two individuals who are committed to being part of GHATI. To apply for the GHATI program, please fill out this form and email it to ghati@acc.org. We will respond with next steps and the onboarding process.

If you have questions that were not answered in the above sections, please reach out to ghati@acc.org.

Participating Sites

If you are a participating site and have questions about GHATI, please see the below questions:

  1. Fields are blocked in data collection sheet. Yes, some columns and cells in the data collection sheet are locked. The data collection sheet is programmed with multiple algorithms to calculate differences in time, mean, median, and other proportions automatically. The sheet is locked so that those algorithms remain intact and standardized for all GHATI facilities.
  2. How do I calculate mean/median? The mean and median are automatically calculated by the algorithm programmed into the data collection sheet. No calculations are required for mean or median values.
  3. What about protocol and IRB? There is no research protocol for GHATI as the aim is to improve the quality of care to patients with STEMI in low- and middle-income countries. Because the participating GHATI facilities are sending aggregated data only (mean, median, proportion) to ACC, no individual patient's data are shared.
  4. Can't enter patient name into data collection sheet. The data collection sheet does not permit entering a patient's name. The field is blocked as a measure to protect the information. If a GHATI site chooses to track a patient by name, they may do so in another document.
  5. Quarter is done, how do I send my data collection sheet to ACC? Please do not send the data collection sheet to ACC or any ACC team members. The spreadsheet can be considered patient identifying information, and we cannot view this information legally.
  6. Transferred patients?
    • If patient was transferred to other facility for CABG, should I enter NO to the discharge medications? This is a great question. We have not been asked about this yet. I am inquiring with our clinical leads on how they would like to proceed here. I will let you know as soon as I have more information.
    • If the patient died, should I enter NO to the discharge medications? If the patient died, you do not have to enter any answer to the discharge medications into the data collection sheet (spreadsheet) – the understanding is that they did not receive discharge medications. When you complete the survey, the denominator for discharge medication questions is the (number of patients discharged alive). So, we will see the correct % of patients who receive discharge medications out of the total number of patients discharged alive.
    • Due to the current situation, those patients that were transferred, I cannot check their arrival time to the referring facility. It is usually not stated in the electronic chart. Most of the time it is in the referral form which is in the record section. How should I answer that column? When we ask for arrival time, we are looking for arrival time at the GHATI facility. So, we would want the date and time that the patient arrived to your facility.

If you have a question that is not answered by the above questions, please email ghati@acc.org and we will respond accordingly.

GHATI has helpful toolkits and guides to support your data collection and gathering.

If you have questions that were not answered in the above sections, please reach out to ghati@acc.org with your questions.

GHATI Workgroup Members 2023-2024

GHATI would like to thank our 2023-2024 Workgroup members for their passion to the GHATI program. We appreciate your dedication to helping hospitals around the world improve AMI care. Thank you for all you do!

  • Dr. Cesar Herrera – Immediate Past Chair
  • Mary Ignacious Bicol, RN – Member
  • Dr. Pedro Barros – Member
  • Dr. Rehan Malik – Member
  • Dr. Alan Fong – Chair
  • Prof. Afzalur Rahman – Member
  • Dr. Miguel Rodriguez Ramos – Member
  • Dr. B.P. Jayagopal – Member

GHATI Sites Committed to Quality Improvement

GHATI would like to congratulate the following sites for their dedication to the GHATI Program, and for consistently and continuously submitting data. Their efforts support the GHATI Program.

CEDIMAT-Centro Cardiovascular
University Clinic for Cardiology, Clinical Centre Skopje
Clínica Bazterrica
National Institute of Cardiovascular Diseases
Hospital General Docente Camilo Cienfuegos
National University Heart Centre
Al-Fouad Cardiac Center
Instituto Nacional de Cardiología Ignacio Chavez
Hospital Samaritano Paulista
The Karen Hospital
Sarawak Heart Centre
Cleveland Clinic Abu Dhabi
Hospital Alemán

Sheikh Kalifa Medical City
The Nairobi Hospital
Assiut University Heart Hospital
Aster MedCity
Hospital de Clínicos de San Lorenzo
Tabba Heart Institute
Shifa International Hospital Ltd
Sanatorio Británico
Hospital General Docente Dr. Ernesto Guevara de la Serna
Lakshmi Hospital
Peshawar Institute of Cardiology
Shifa Cardiology Center