Guidelines for therapy of ST-segment-elevation acute myocardial infarction in patients presenting to Partners Healthcare system hospital emergency departments

Abstract

A major focus for individuals and organizations that study the quality of cardiovascular care is the timeliness of treatment for those patients who suffer an acute ST-elevation myocardial infarction (STEMI). We sought to develop guidelines that would inform the development and management of a more standardized approach to the treatment of STEMI within the 5 acute care hospitals that make up the Partners Healthcare acute care hospital network. In recent years much has been learned about how to deliver timely reperfusion therapy in STEMI and how to assess its outcome. As a component of the organization's mandate to promote the uniform high quality of care throughout the system, our group began studying the many aspects of the current treatment of STEMI within the system, we reviewed, summarized and debated the relevant literature, studied best practices and made recommendations for a system-wide approach to this problem. Our methods have included literature review, consultation with local and national experts, site visits throughout the system, web-based surveys of current attitudes within the system, interviews with stakeholders and consensus-development conferences. The result was not only the development of the following guidelines for therapy, but also an ongoing commitment to share patient-level data and outcomes for continuous quality assessment and improvement.