Key result
Regional STEMI systems linked to a ~41% increase in formal management protocols at community hospitals.
Why the study?
Since the 1990s, national guidelines recommended STEMI treatment protocols and quality monitoring, but a 2003 survey showed many Minnesota hospitals without CCL lacked complete protocols and QA processes.
Does the implementation of regional STEMI systems improve protocol use and reduce mortality in community hospitals without cardiac catheterization laboratories?
Population
Emergency departments at 108 Minnesota hospitals without cardiac catheterization laboratories
Comparison
STEMI processes and protocol use in 2010 versus 2003
Design
Observational survey study with follow-up surveys
Authors
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Regional systems associated with higher protocol use in community hospitals; leaves open mortality impact in observational data.
Observational (n=108)
Yes
Does the implementation of regional STEMI systems improve protocol use and reduce mortality in community hospitals without cardiac catheterization laboratories?
Absolute Event Rate: 89% vs 63%
p-value: p=<0.001
The growth of regional STEMI systems significantly improved guideline and protocol utilization in community hospitals without catheterization labs, paralleling a decline in STEMI mortality.
Handran et al. (2021) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=108). Regional STEMI systems vs. 2003 baseline (prior to widespread regional systems) was evaluated on Presence of formal protocols or guidelines for STEMI management (p=<0.001). The implementation of regional STEMI systems increased the presence of formal STEMI management protocols in community hospitals from 63% in 2003 to 89% in 2010 (p<0.001).
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