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Protocol-driven heart attack care proves effective and contagious
Date:4/4/2011

The implementation of acute heart attack or ST-elevation myocardial infarction (STEMI) guidelines, protocols and standing orders in Minnesota community hospitals without cardiac catheterization labs has dramatically improved since 2003, according to a scientific poster that will be presented at the American College of Cardiology (ACC) Scientific Sessions in New Orleans, April 1-3.

Since the 1990s, the American College Cardiology (ACC)/American Heart Association (AHA) STEMI guidelines recommended that all hospitals develop protocols and standing orders (reperfusion strategy, adjunctive medications, transfer criteria) for STEMI and monitor quality measures (time to treatment and adjunctive medications).

In 2003, a survey of Minnesota hospitals without cardiac catheterization labs found less than 70 percent of hospitals had any protocols and less than 50 percent had a formal quality improvement process and many were "incomplete or inadequate," explained the study's senior author Timothy D. Henry, MD, interventional cardiologist at Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis and Director of Cardiovascular Research at Minneapolis Heart Institute Foundation. He described the 2003 survey results as "surprising and a major public health problem."

However, those findings stimulated the development of several regional STEMI systems in Minnesota, including the Level 1 Heart Attack Network created by the Minneapolis Heart Institute. "At this point, almost every hospital in the state belongs to a STEMI network due to their proliferation after 2003," Henry noted.

To compare performance since the 2003 survey results, the researchers mailed the identical survey to emergency department medical directors and nurse managers at all 108 Minnesota hospitals without cardiac catheterization labs in late 2009.

Since 2003, implementation of STEMI guidelines, protocols and standing orders in Minnesota commu
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Contact: Meghan Bethke
mbethke@mhif.org
612-863-5410
Minneapolis Heart Institute Foundation
Source:Eurekalert

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