1. Improving the System of Care for STEMI Patients 1

2. Welcome to the Fall 2010 STEMI Summit Jodi Doering, RN Mission:Lifeline Director State of South Dakota Judy James Regional Mission:Lifeline Director Midwest Affiliate, AHA 2

3. Improving the System of Care for STEMI Patients A Life-Saving Initiative National, community-based initiative Goals Improve quality of care and outcomes in heart attack patients Improve health care system readiness and response 3

4. Improving the System of Care for STEMI Patients Mission Lifeline: Class 1 Recommendation 4

5. Improving the System of Care for STEMI Patients April, 2010 The Leona M and Harry B Helmsley Foundation gave $8.4 million to the AHA to develop a cutting edge state wide STEMI system of care!!!! 5 This will revolutionize heart attack patient care in SD – we currently have one of the highest STEMI death rates in the US according to the CDC. This project is designed to produce a “model system” that can then be implemented across the Midwest and nation, making SD a leader in heart attack systems of care.

6. Improving the System of Care for STEMI Patients What does Mission: Lifeline mean for South Dakota? Mission: Lifeline is the American Heart Association's national initiative to advance the systems of care for patients with ST-segment elevation myocardial infarction (STEMI). The overarching goal of the initiative is to reduce mortality and morbidity for STEMI patients and to improve their overall quality of care.

7. Improving the System of Care for STEMI Patients Why a STEMI system in South Dakota? 7

8. Improving the System of Care for STEMI Patients STEMI Chain of Survival

9. Improving the System of Care for STEMI Patients Project Budget Highlights EMS: $4M $3.5M for 12-Leads $225K for transmission $300K for training & materials Hospitals: $3M $775K for 12-Lead receiving station software $2M for ACTION Registry GWTG $75K for Fibrinolytic Training

10. Improving the System of Care for STEMI Patients Project Budget Highlights…. Other highlights: Full Time SD M:L Director Annual Conferences in SF & RC Public/Provider Education Evaluation Positioning SD as a leader

11. Improving the System of Care for STEMI Patients The Uniqueness of Mission: Lifeline Mission: Lifeline will: Promote the ideal STEMI systems of care Help STEMI patients get the life-saving care they need in time Bring together healthcare resources into an efficient, synergistic system Improve overall quality of care The initiative is unique in that it: Addresses the continuum of care for STEMI patients Preserves a role for the local STEMI-referral hospital Understands the issues specific to rural communities Promotes different solutions/protocols for rural vs. urban/suburban areas Recognizes there is no “one-size-fits-all” solution Knows the issues of implementing national recommendations on a community level 11

12. Improving the System of Care for STEMI Patients Today’s Conference will help identify these things: Ideal Patient Ideal EMS Ideal PCI Referring Hospital Ideal PCI Receiving hospital 12

13. Improving the System of Care for STEMI Patients Partners for Success Patients and care givers EMS providers Physicians, nurses and other providers STEM-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 13

14. Improving the System of Care for STEMI Patients What it means to SD? Successful implementation of Mission: Lifeline will mean that South Dakota will have: One of the most advanced, if not the most advanced, coordinated heart attack systems of care in the United States The highest percentage of ambulance services in the nation equipped with 12-lead ECGs The highest percentage of 12-lead ECG-trained emergency medical technicians in the nation The highest percentage of ambulance services transmitting 12- lead ECG results in the nation

15. Improving the System of Care for STEMI Patients

17. EMS Training & Materials Hands on Training Learn: Rapid STEMI ID online tool STEMI Provider Manual Every SD Ambulance Service Every EMT

18. Improving the System of Care for STEMI Patients Hospitals 12-Lead ECG Receiving capability Action Registry – Get with the Guidelines (ARG) Fibrinolytic Therapy Training

19. Improving the System of Care for STEMI Patients ACTION – Registry GWTG Data Collection Tool developed by AHA/ACC Focused on entire continuum of care QI Staff & Webinars

20. Improving the System of Care for STEMI Patients How will the grant work? Each EMS agency will be contacted by me for their allotted number of heart monitors they will receive. EMS agencies should evaluate the 3 vendors for 12-leads now Each hospital will be contacted by me for their allotted funds for 12-lead receiving as well as the data component Hospitals should work with their local EMS as they choose their 12-lead vendors ° Each EMS agency and Hospital needs to fill out a W-9 to be set up as a vendor with the AHA to receive their funds ° Each EMS agency and hospital will need to sign an agreement ° Monies will be distributed to the EMS, EMS will pay the vendor ° Education component will come to every hospital, every EMAT in the state 20

21. Improving the System of Care for STEMI Patients 21 jodi.doering@heart.org