A Team Approach to Establishing Regional Systems of Care for STEMI
David M. Janicke, MD, PhD
Associate Professor of Emergency Medicine
Department of Emergency Medicine
State University of New York at Buffalo
Director, Emergency Medicine
Millard Fillmore Gates Circle Hospital
Buffalo, New York
Essential elements in the care of patients with ST-segment elevation myocardial infarction (STEMI) are rapid, accurate diagnosis and keeping the encounter time to reperfusion as short as possible. The choice of method of reperfusion is based on an individual hospital's capability and the time to percutaneous coronary intervention (PCI), whether directly or via transfer, relative to fibrinolytic therapy. The American College of Cardiology/American Heart Association (ACC/AHA) 2009 joint STEMI/PCI focused update recommends that each community develop a STEMI system of care that follows standards at least as stringent as those developed for the AHA's Mission: Lifeline initiative. It should include ongoing multidisciplinary team meetings with emergency medical services (EMS), STEMI referral centers, and STEMI receiving centers; a process for prehospital identification and activation; destination protocols for STEMI receiving centers; and transfer protocols for STEMI referral centers. Ensuring that all patients receive optimum care requires having protocols in place, working together as a team, tracking time to treatment, and minimizing system-based errors.
Method of Participation and Evaluation
To participate in this CME activity, please read the following information and click "Launch Program" at the bottom of this page. Complete the online evaluation at the conclusion of the activity. You may print your certificate immediately after completion of the evaluation. Please note: To view this program you need a computer with an Internet browser and audio and video capabilities.
Up to 0.5 AMA PRA Category 1 Credit™
This activity is designed for emergency medicine physicians, cardiologists, primary care physicians, and other healthcare professionals interested in the diagnosis and treatment of acute coronary syndromes.
After taking part in this CME activity, participants should be able to:
- Identify ways to improve care for patients with STEMI through systems that integrate EMS, emergency medicine, and cardiology
- Outline current ACC/AHA guideline recommendations for the use of PCI and thrombolysis in patients with STEMI
- Employ a multidisciplinary team approach to establishing regional systems of care for STEMI
David M. Janicke, MD, PhD
David M. Janicke, MD, PhD, has received honoraria from Bristol-Myers Squibb Company, Genentech, Inc., and sanofi-aventis.
The Foundation for Improving Patient Outcomes staff and the independent peer reviewer report no financial relationship with commercial interests.
CME Credit Designations
ACCME The Foundation for Improving Patient Outcomes (FFIPO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA FFIPO designates this educational activity for a maximum of .5 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AOA This activity is eligible for up to 0.5 hour of credit in Category 2-A of the American Osteopathic Association.