2022 Quality Summit ePosters (Non-CE) - Chest Pain-MI Registry-9. Improving Timely Reperfusion for ST-Elevation Myocardial Infarction (STEMI) Patients Transferred from Non-PCI Centers

9. Improving Timely Reperfusion for ST-Elevation Myocardial Infarction (STEMI) Patients Transferred from Non-PCI Centers

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Pdf Summary

The document discusses efforts to improve timely reperfusion for ST-Elevation Myocardial Infarction (STEMI) patients transferred from non-PCI centers. The problem statement highlights longer referring door to device (RD2D) times and under-utilization of thrombolytic therapy in these patients. The objective was to improve the timeliness of reperfusion using PCI or thrombolytic approaches.<br /><br />The methodology involved reviewing STEMI transfers from non-PCI centers over an 18-month period and identifying opportunities for improvement, such as variations in the transfer acceptance process, concerns about thrombolytic discussion with non-PCI centers, and delays in STEMI team activation. Action plans were developed, including changes to the STEMI activation alert process, confirmation and sharing of the transfer process, development of a STEMI acceptance form, and distribution of revised referring guidelines to non-PCI centers.<br /><br />The value proposition of decreasing time to reperfusion for referred patients from non-PCI facilities is expected to reduce long-term complications of myocardial infarction and improve the health of communities. The document also mentions an increase in thrombolytic use and an improvement in time to Primary PCI among transferred patients. However, there was an increase in median time from referring door to reperfusion.<br /><br />The conclusions highlight the complexity of the referring door to reperfusion process and emphasize the importance of collaboration among facilities and transport services to positively impact patient health. The document acknowledges the small sample size and the need for additional work to develop a consistent system with adequate resources for timely reperfusion. The methodology involved using metrics from the National Cardiovascular Data Registry (NCDR) Chest Pain - MI Registry to evaluate success, along with internal metrics for thrombolytic use and transfer acceptance.<br /><br />Overall, the document outlines efforts to improve timely reperfusion for STEMI patients transferred from non-PCI centers and provides insights into the challenges and opportunities in optimizing the STEMI system of care.

Keywords

ST-Elevation Myocardial Infarction

STEMI patients

non-PCI centers

timely reperfusion

thrombolytic therapy

PCI

transfer acceptance process

thrombolytic use

Primary PCI

referring door to reperfusion process