Implementation Plan

Updated:Oct 25,2012

To meet our goal, Mission: Lifeline will bring together the necessary partnerships between:
    • Patients and care givers
    • EMS
    • Physicians, nurses and other providers
    • STEMI referral (non-PCI) hospitals
    • STEMI-receiving (PCI-capable) hospitals
    • Health systems
    • Departments of Health
    • EMS regulatory authority/office of EMS
    • Rural health associations
    • Quality improvement organizations
    • Third-party payers
    • State and local policymakers

For each component of the STEMI system of care, Mission: Lifeline will:

    • Define the ideal practice
    • Recommend strategies to achieve the ideal practice
    • Provide resources/tools to achieve the ideal practice
    • Recommend metrics for structure, process and outcomes
    • Recommend criteria for recognition and certification in a comprehensive system design

Mission: Lifeline's approach to developing a new system of STEMI treatment includes a number of coordinated actions:

    • Assess and improve the emergency medical services (EMS) system
    • Establish local initiatives
    • Evaluate existing models
    • Explore the possibility of developing a national STEMI-certification program and/or criteria
    • Launch Mission: Lifeline Awareness campaigns
    • Create system resources
    • Engage strategic alliances


Phase 1


This map illustrates phase 1 of implementation, current STEMI systems of care.


Phase 2


This map illustrates phase 2 of implementation, as more and more STEMI systems of care are developed.


Phase 3


At the end of the projected three- to five-year implementation, it is projected that Mission: Lifeline will have helped establish STEMI systems of care across the entire country.

Assess and improve the emergency medical services (EMS) system
To carry out this area of focus, the American Heart Association will:

    • Collaborate with EMS organizations in a needs assessment and analysis of EMS effectiveness when responding to STEMI patients as part of a STEMI system of care
    • Develop a plan to build a system to serve STEMI patients that can be tailored as necessary to the appropriate region or state
    • Develop Emergency Cardiovascular Care (ECC) education and training
    • Build out Point of Entry (POE) protocols
    • Develop quality measurements and standards to assess the effectiveness of early activation of EMS and recommended transport protocols
    • Support policy and appropriations that enhance EMS capacity
    • Address funding challenges
    • Evaluate existing process measures and patient outcomes

Establish local initiatives
To carry out this area of focus, the American Heart Association is:

    • Establishiing and convening state and regional Mission: Lifeline stakeholders, including patients, physicians, policymakers and others
    • Identifing ways to implement national recommendations for STEMI systems in local communities with attention to issues such as geography, resources and existing programs

Evaluate existing models
The American Heart Association has convened a group of thought leaders to review existing local or regional pilot programs for STEMI Systems of Care.  The existing pilots will be evaluated for the following:

    • Financial impact on STEMI referral and receiving hospitals and EMS;
    • Rural implications and inclusion;
    • Overuse and potential for false-positives; 
    • Disparate population impact; 
    • Resource allocation in regional area;
    • Allocation of resources within STEMI receiving hospital to accommodate additional patient volume; and
    • Other criteria as deemed appropriate.

Explore the possibility of developing a national STEMI-certification program and/or criteria
The American Heart Association, in collaboration with other patient-focused organizations, will develop recommendations for recognition and certification of EMS and STEMI Referral and Receiving hospitals and ultimately for the regional STEMI system.