An Organized “Systems” Approach Improves STEMI Care

There is substantial evidence that rapid percutaneous coronary intervention (PCI) reduces morbidity and mortality in patients with ST-segment-elevation myocardial infarction (STEMI). Researchers conducted a quality improvement study to assess the effect of establishing a statewide system of reperfusion therapy for STEMI. The program involved five regions in North Carolina (covering roughly two thirds of the state’s population and hospitals) and involving 65 hospitals (10 PCI-capable, 55 non–PCI-capable) and their associated emergency medical services systems. Each region developed strategies to help ensure early diagnosis, rapid transport from the scene or transfer to a PCI hospital, and use of the most expedient PCI method available. The P…