Development of Systems of Care for ST-Elevation Myocardial Infarction Patients

The physician’s overarching role in the development of systems of care for ST-segment–elevation myocardial infarction (STEMI) is to advocate for achieving the goal of early infarct-artery patency for all patients with STEMI. An effective STEMI care system relies on a team of multiple physicians, nurses, emergency medical services (EMS) personnel, and other providers to work in an efficient, collaborative manner to deliver optimal patient care. Urgent, direct activation of the EMS system by the STEMI patient is ideal.Successful first response care by EMS or emergency department (ED) personnel followed by rapid access to revascularization requires standardized, evidence-based STEMI treatment protocols in accordance with the most current American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. Physicians participating in the development of these protocols should include both interventional and noninterventional cardiologists, emergency medicine specialists, EMS physicians, and primary care physicians. Furthermore, to more effectively achieve success in developing and implementing these systems and networks, physicians must demonstrate a new paradigm of leadership, including the following:1. A passionate and credible commitment to the goal of achieving timely infarct artery patency for all patients with STEMI;2. An ability to obtain the full cooperation, collaboration, and support of hospital senior management and medical staff at local, referral, and regional levels;3. The development and implementation of innovative team-based methods for overcoming professional, organizational, and regulatory barriers to ideal STEMI treatment;4. Effectiveness in implementing protocols that are flexible with regard to geographic and other local issues;5. Mastery of the use of efficient and credible clinical information systems that support timely data collection, quality and outcomes measurement, feedback, and transparency for both internal and public quality improvement initiatives; and6. Prompt data collection and feedback.Currently, primary care and specialist physicians tend to work separately rather than in integrated networks in caring for patients with STEMI, particularly …