In the ideal STEMI system of care, standardized point of entry protocols dictate the STEMI patients to be transported directly to a STEMI-receiving (PCI-capable) hospital based on:

• Specific criteria for risk
• Contraindications to fibrinolysis
• The proximity of the nearest PCI service

Those patients transported by EMS or who arrive via self-transport (or via family or friends) at a STEMI Referral hospital would be treated according to standardized triage and (potential) transfer protocols.

Incentives are provided to rapidly:

• Treat STEMI patients in accordance with American Heart Association and American College of Cardiology guidelines
• Transfer to the STEMI-Receiving hospital for primary PCI using reperfusion checklists, standard pharmacological regimens and order sets, clinical pathways with attention to details such as eliminating continuous intravenous infusions and tubing
• Promote efficient data transfer (using Mission: Lifeline Bridging Form) to the STEMI-Receiving hospital as well as integrate data collection and feedback into the system of care

• Integrate plans for return of the patient to the local community for follow-up care following discharge from the STEMI-Receiving hospital on a routine basis

Refer to the Mission: Lifeline recommendations for quality improvement recognition and certification.