In the ideal system, pre-hospital ECG diagnosis of STEMI, ED notification and catheterization laboratory activation would occur according to standard algorithms that would facilitate a short ED stay or transport directly from the field to the catheterization laboratory. Similarly, single call systems from STEMI Referral hospitals with universal patient acceptance by STEMI-Receiving hospitals would result in immediate activation of the catheterization laboratory team without the need for additional review or determination of bed availability.
Primary PCI would be provided as routine treatment for appropriate STEMI patients 24 hours per day and seven days per week and STEMI-Receiving hospitals would never be on diversion. Each STEMI-Receiving hospital would have a written commitment from the hospital's administration to support the program. A multidisciplinary group with representation for the ED, EMS, the cardiac catheterization laboratory, the quality improvement team, and the coronary care unit that includes both physicians and nurses would meet regularly to identify problems and implement solutions. A formal continuing education program that includes practical implementation training for staff would be designed and instituted. A mechanism for monitoring program performance, process measures, and patient outcomes would be established.
Learn about strategies STEMI-receiving hospitals can use to achieve the ideal practice.