Developing Regional STEMI Systems of Care: A Review of the Evidence and the Role of the Flex Program (Policy Brief #23)

Publication Date: Nov 2011
Author(s): Gale J
Research Center(s): Maine
Project: Strategies for Improving the Safety of Care Delivered by Critical Access Hospitals
Topic(s): EMS, Flex Program, Health Care Services
Notes: Policy Brief #23

This policy brief summarizes the evidence for regional systems of care for patients presenting with ST-segment elevation myocardial infarction (STEMI). These systems of care have both a quality improvement and a systems development focus and provide a valuable opportunity for State Flex Programs to engage CAHs and EMS in rationalizing and improving STEMI care for rural residents, particularly with respect to MBQIP Phase 2 Measures.

Key Findings:

  • CAHs and rural EMS agencies play an important role in STEMI systems of care.
  • EMS providers use pre-hospital ECGs and transport protocols to ensure timely reperfusion.
  • CAHs provide fibrinolytic therapy and post-reperfusion followup care including cardiac rehabilitation.
  • State Flex Programs can facilitate involvement of CAHs and EMS agencies in STEMI systems of care.