使命:生命线® STEMI 加速器I和II Regionalizing STEMI Care Demonstration Projects
杜克临床研究所, in collaboration with the 美国心脏协会 led and conducted the Regional Systems 加速器I和II Projects. 这两项研究, 独立的:彼此独立进行的, focus on the implementation of The 美国心脏协会’s 使命:生命线 program in regions of high population and with complex components of a STEMI System of Care.
ACC/AHA STEMI Guidelines include Class I recommendation that “all communities should create and maintain a regional system of STEMI care that includes assessment and continuous quality improvement of EMS and hospital-based activities.” Both Accelerator projects sought to achieve guideline-based STEMI care through intensive implementation of 使命:生命线.
| STEMI加速器STEMI接收中心项目参与者 | STEMI Accelerator II STEMI Receiving Center Project Participants |
| 亚特兰大,乔治亚州 | 奥尔巴尼,纽约 |
| 贝克斯菲尔德, | 辛辛那提,哦 |
| 科罗拉多州(东山脉) | 康涅狄格 |
| 哥伦布,哦 | 科罗拉多州丹佛市 |
| 哈特福德CT | 东肯塔基州(列克星敦) |
| 夏威夷 | 休斯顿,德克萨斯州 |
| 休斯顿,德克萨斯州 | 拉斯维加斯，内华达州 |
| 肯塔基州路易斯维尔市 | 阿肯色州小石城 |
| (北)新泽西 | 纽约，纽约 |
| 纽约，纽约 | 波特兰,或 |
| 费城,宾夕法尼亚州 | 西雅图,华盛顿州 |
| 宾夕法尼亚州匹兹堡 | 潮水地区，弗吉尼亚州 |
| 圣安东尼奥，德克萨斯州 | |
| 宾夕法尼亚州斯克兰顿 | |
| St. 路易斯,莫 | |
| 佛罗里达州坦帕的 |
| 地区数量 | 线上电子游戏飞禽走兽 | 患者人数 | 医院数目 | EMS服务机构数目 | |
| STEMI加速器I项目 | 16 | 2012年7月至2013年12月 | 23,809 | 484 | 1253 |
| STEMI加速器II项目 | 12 | 2015年4月- 2017年3月 | 21,160 | 132 | 946 |
使命:生命线 STEMI 加速器I和II Project Program Goals and Objectives:
- Markedly accelerate development and improvement of regional STEMI Systems of Care by:
- 确定强有力的区域保健冠军系统
- Forming strong, self-sustaining regional 使命:生命线 Task Force(s)
- 区域诊断方案
- 区域治疗方案
- 统一数据收集
- 及时一致的数据反馈
- Build on the Accelerator I Project to create regional response to STEMI emergency care in a timely, coordinated and consistent manner including EMS FMC to device within 90 minutes or Arrival at STEMI referring hospital to PCI within 120 minutes, for those patients not receiving fibrinolytic therapy and transferring for Primary PCI.
- Establish regional leadership in emergency cardiac care that includes passionate and respected thought leaders to include physicians, 护士, 管理员, and public health officials representing hospitals emergency medicine, 心脏病学, 和EMS. The leaders would build consensus regarding regional solutions to coordinated care and form a regional executive leadership team.
- 实现, monitor and maintain the intervention through partnerships between local stakeholder organizations, 区域AHA领导和国家专家. (医院医师领导, EMS机构, and regions may establish these partnerships through a memorandum of cooperation (MOC) between individual institutions, agencies and systems to create regional quality improvement teams.
使命:生命线 STEMI Accelerator Program Metrics/Regional and Hospital Targets
- 75% or more of STEMI Receiving Centers in the region participating in the project to enroll in 使命:生命线 data platform, submit STEMI data and participate in 使命:生命线 Regional Reports
- Show positive improvement trends in regional performance for metrics included below:
- 90分钟内从急救中心转到PCI
- 120分钟内到达STEMI转诊医院行PCI治疗
- 总体关键过程和临床结果
任务:生命线STEMI加速器项目结论
- The 使命:生命线 STEMI Systems Accelerator demonstration project represents the largest national effort to organize regional STEMI care. 通过关注第一次医疗接触到设备的线上电子游戏飞禽走兽, 协调治疗方案, 以及区域数据收集和报告, the proportion of patients treated within guideline goals was increased.
来源: 2016 使命:生命线 Regional Systems of Care Demonstration Project (Accelerator I)(链接在新窗口中打开) - Organization of care among EMS and hospitals in 12 regions was associated with significant reductions in time of reperfusion in patients with STEMI, 住院死亡率. These findings support a more intensive regional approach to emergency care for patients.
来源:2018 Impact of Regionalization of STEMI Care on Treatment Times and Outcomes for EMS - Transported Patients Presenting to Hospitals With PCI (使命:生命线 Accelerator II Project)
使命:生命线STEMI加速器I和II出版物
- 2018 Impact of Regionalization of STEMI Care on Treatment Times and Outcomes for EMS - Transported Patients Presenting to Hospitals With PCI (使命:生命线 Accelerator II Project)(链接在新窗口中打开)
- 2016 使命:生命线 Regional Systems of Care Demonstration Project (Accelerator I)(链接在新窗口中打开)
- 任务:生命线加速器I项目
- 2016 Editorial The Challenge to 实现 Systems of Care for STEMI(链接在新窗口中打开)
- 2011: STEMI区域综合护理的需求(链接在新窗口中打开)
Additional 使命:生命线 STEMI 加速器I和II Resources
- Regional Systems of Care Demonstration Project: 使命:生命线 STEMI Systems Accelerator Manual(链接在新窗口中打开)
- Final Results: 使命:生命线 STEMI Accelerator I Demonstration Project(链接在新窗口中打开)
To learn how you can participate in regionalizing 使命:生命线 STEMI Systems of Care complete the 获取更多关于使命:生命线的信息(链接在新窗口中打开) form. An AHA Quality and Systems Improvement team member will contact you within 48 hours.
