Why the study?
A rural mountain hospital consistently experienced first medical contact-to-device times of >=90 minutes for STEMI patients, threatening safety, quality benchmarks, and Chest Pain Center Accreditation.
Does a multifaceted, multiagency quality improvement initiative including standardized field activation protocols, targeted education, and the Pulsara communication platform reduce first medical contact-to-device times in STEMI patients at a rural mountain hospital?
Does a multifaceted, multiagency quality improvement initiative including standardized field activation protocols, targeted education, and the Pulsara communication platform reduce first medical contact-to-device times in STEMI patients at a rural mountain hospital?
Implementing a multidisciplinary, multiagency quality improvement initiative utilizing standardized field activation, real-time communication technology, and timely case feedback substantially improved the proportion of rural STEMI patients achieving guideline-recommended FMC-to-device times of ≤90 minutes from 50%-66.7% to 95%.
Answers are grounded in this paper and cite their sources.
Offers a model for rural STEMI care; leaves open generalizability beyond this single center.
BACKGROUND: CommonSpirit Mercy Hospital, a rural mountain hospital, consistently experienced a first medical contact-to-device time of ≥90 minutes for patients with ST-segment elevation myocardial infarction (STEMI), which threatened patient safety and outcomes, quality benchmarks, and achievement of Chest Pain Center Accreditation. PROJECT RATIONALE: In 2024, 60% of the FMC-to-device time for STEMI patients was ≥90 minutes (average: 111 minutes). In response, the quality improvement team analyzed data from the National Cardiac Data Registry's Chest Pain-MI Registry, identified gaps in prehospital STEMI activation processes, and built a multiagency collaboration. PROJECT SUMMARY: A multidisciplinary team implemented targeted outreach, education, and simulation training across regional emergency medical services agencies and internal emergency department teams. The project introduced standardized field activation protocols and the Pulsara platform for real-time communication, along with case summary follow-up and targeted improvement strategies. TAKE-HOME MESSAGES: Rural hospital settings present unique challenges to achieving guideline-recommended STEMI care. Measurable STEMI care improvement can be achieved by approaching the process with authenticity, enthusiasm, and a focus on stakeholder relationships.
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Shelley Langenhorst (2025) studied this question.
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