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

T he establishment of systems to improve the quality of care for ST-elevation myocardial infarction (STEMI) patients holds great promise to facilitate patients' access to evidence-based, timely cardiac therapies and, ultimately, to improve patient outcomes. Any evaluation of the quality of STEMI care should be focused squarely on the patient, from initial symptom onset to rapid access to reperfusion therapy and through a coordinated hospital discharge and return to the community. Ideal care therefore requires close collaboration of multiple parties, including the patient, emergency medical services (EMS), emergency physicians, interventional teams, cardiologists, and community-based clinicians. As with any care system, however, attempts to improve the process may not be implemented successfully or, worse, may lead to unintended adverse consequences. As such, it is important to carefully monitor the impact of any new care strategies on clinical outcomes.