Development of Systems of Care for ST-Elevation Myocardial Infarction Patients

Mensah, George A.; Hand, Mary M.; Antman, Elliott M.; Ryan, Thomas J.; Schriever, R.; Smith, Sidney C.

doi:10.1161/circulationaha.107.184045

Cited by 26 publications

(13 citation statements)

References 24 publications

(26 reference statements)

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“…The reasons for the persistence of this finding are not entirely clear, but cost, fear of false alarm, reluctance to bother or burden the medical community, lack of EMS benefit awareness, and other psychosocial factors, such as lack of trust in others have been implicated. 12,13 In contrast to the National Registry of Myocardial Infarction survey 7 and other previous work, 14,15 race was no longer a significant factor implicated in the decision regarding mode of transport in our contemporary population; however, patients of younger age, male sex, and Hispanic ethnicity persistently underuse EMS and therefore should remain targets of community education campaigns. 7 Interestingly, we found that education level was not a major predictor of mode of transport, and in contrast to prior studies, 16 we found that rural residence was also not a major predictor.…”

Section: Underuse Of Emergency Medical Services Transportcontrasting

confidence: 77%

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

et al. 2011

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Background-Activation of emergency medical services (EMS) is critical for the early triage and treatment of patients experiencing ST-segment-elevation myocardial infarction, yet data regarding EMS use and its association with subsequent clinical care are limited. Methods and Results-We performed an observational analysis of 37 634 ST-segment-elevation myocardial infarction patients treated at 372 US hospitals participating in the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines between January 2007 and September 2009, and examined independent patient factors associated with EMS transportation versus patient self-transportation. We found that EMS transport was used in only 60% of ST-segment-elevation myocardial infarction patients. Older patients, those living farther from the hospital, and those with hemodynamic compromise were more likely to use EMS transport. In contrast, race, income, and education level did not appear to be associated with the mode of transport.

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Section: Underuse Of Emergency Medical Services Transportcontrasting

confidence: 77%

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

et al. 2011

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“…5,6 To understand patient and family fears and expectations better, we sought to assess the effect on patients and families of transfer for emergent PCI with the ultimate goal to improve not only the quality of care but also the experience itself.…”

mentioning

confidence: 99%

Satisfaction With Emergent Transfer for Percutaneous Coronary Interventions on Patients With ST–Segment-Elevation Myocardial Infarction and Their Families

Henry

Christiansen

Garberich

et al. 2014

Circ: Cardiovascular Quality and Outcomes

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Background-Transfer for primary percutaneous coronary intervention (PCI) is superior to fibrinolysis if performed in a timely manner but frequently requires dislocation of patients and their families from their local community. Although patient satisfaction is increasingly viewed as an important quality indicator, there are no data on how emergent transfer for PCI affects patients with ST-segment-elevation myocardial infarction and their families. Methods and Results-The Minneapolis Heart Institute's Level 1 Regional ST-Segment-Elevation Myocardial Infarction program is designed to facilitate emergent transfer for PCI in patients with ST-segment-elevation myocardial infarction from 31 rural and community hospitals. To determine the effect of emergent transfer, questionnaires were given to 152 patients and their families who survived to hospital discharge with a 65.8% response rate (mean age, 63.9 years; 29% women). Ninety-five percent of patients felt the reasons and process of transfer were well explained, and 97% felt transfer for care was necessary. Despite this, 15% of patients would have preferred to stay in their local hospital. The majority of the families felt the transfer process (88%) and family member's condition (94%) were well explained. Although 99% felt it was necessary for their family member to be transferred for specialized care, 11% of families still would have preferred that their family members remain at the local community hospital. Conclusions-Our results suggest that ST-segment-elevation myocardial infarction patients and families can be informed, even in time-critical situations, about the transfer process for PCI and understand the need for specialized care. Still, a significant minority would prefer to stay at their local hospital, despite acknowledging transfer for PCI provided optimal care. (Circ Cardiovasc Qual Outcomes. 2014;7:244-250.)Key Words: patient education as topic ◼ quality of health care ◼ ST-elevation myocardial infarction ◼ systems of care

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“…As discussed in "The Patient and Public Perspective" section of these conference proceedings, 3 patients and their families may not understand why a transfer or bypass to a primary PCI-capable hospital is preferable. Identifying some of the consumer concerns with the systems at the onset may help to positively affect the patient and family experience in bypassing their preferred hospital or in interhospital transfer.…”

Section: Constituents Should Be Brought Together To Develop Strategiementioning

confidence: 99%

Development of Systems of Care for ST-Elevation Myocardial Infarction Patients

Solis

Amsterdam²,

Bufalino³

et al. 2007

Circulation

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he establishment of timely access to primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) patients holds great promise for improving quality of care and patient outcomes. As described in other sections of these conference proceedings, there are significant barriers to the establishment of the ideal system. Changes in policy will be required to overcome many of the obstacles that preclude the delivery of optimal care for all STEMI patients. Short-and long-term policy recommendations that can foster an ideal STEMI system environment are described below. These recommendations focus on how to maximize opportunities to improve the care of STEMI patients by enhancing the processes that are currently available but not fully implemented.

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Development of Systems of Care for ST-Elevation Myocardial Infarction Patients

Cited by 26 publications

References 24 publications

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

Satisfaction With Emergent Transfer for Percutaneous Coronary Interventions on Patients With ST–Segment-Elevation Myocardial Infarction and Their Families

Development of Systems of Care for ST-Elevation Myocardial Infarction Patients

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