What is STEMI? What does it mean to me?
Physicians and staff at Forrest General are making a difference in the lives of patients who suffer from the most serious kind of heart attack through participation in the STEMI Care System. The STEMI Care System is a network of hospitals that have implemented a process designed to deliver care within minutes to patients experiencing a heart attack called an ST Elevation Myocardial Infarction, or STEMI.
Several hospitals in south Mississippi participate in the STEMI Network, including Forrest General, South Central Regional Medical Center in Laurel, Highland Community Hospital in Picayune, Walthall General Hospital, Marion General Hospital, Covington County Hospital, Perry County Hospital, Greene County Hospital, Pearl River County Hospital and Wayne General Hospital.
The STEMI Network was put in place through the efforts of the Mississippi Healthcare Alliance, which features North, Central and Southern Divisions and is supported by 19 healthcare facilities across the state that perform emergency angioplasty for heart attack patients. Forrest General received the American Heart Association's Mission: Lifeline Silver Quality Achievement Award recognizing outstanding care of STEMI Heart Attack patients.
Forrest General Hospital's STEMI Care System
Forrest General Hospital’s STEMI Care System is making a difference in the lives of south Mississippians who suffer an ST Elevation Myocardial Infarction or STEMI. In STEMI care, the most important therapy to reduce mortality and morbidity rates is rapid reperfusion therapy by Primary Percutaneous Intervention. (balloon angioplasty). Our goal and the standard is to achieve Door to Balloon (D2B) times of 90 minutes or less in 75% of patients who present to our ED with STEMI and to achieve Door to Balloon time of 120 minutes or less in transferred in patients.
History about the STEMI Care System at Forrest General
In 2010, our average D2B time for patients presenting to Forrest General Hospital was 60 minutes with 96% of patients achieving a D2B time less than 90 minutes. In 2012, our average D2B time for patients presenting to Forrest General Hospital was 50.5 minutes with 10% of patients achieving a D2B time less than 90 minutes.
Also in 2010, our average D2B time for patients from transferring hospitals was 140+ minutes, In 2012, thanks to great cooperation from everyone involved, our average D2B time for transfers was 92 minutes.
There is now an emphasis on shortening not just D2B but First Medical Contact to Balloon. This takes into account, in cases where 911 is called, when the EMS provider reaches the patient. The moment the EMS provider reaches the patient is the First Medical Contact time. Our goal and the standard is to achieve First Medical Contact to balloon within 90 minutes or less in 75% of patients.
In 2011 we met this goal less than 50% of the time. However, thanks to a lot of hard work and dedication, in 2012 we met this goal 85% of the time during the first two quarters of the year and 100% of the time during the last two quarters of the year.
Our success has been due to efforts of multiple departments and personnel from the Cardiology Department, Cardiac Cath Lab, Emergency Department, Transfer Facilities, EMS Services and Administration. The following processes continue to make our STEMI program compare favorably with the state and national averages:
Learn about the STEMI, the STEMICommittee at Forrest General
The STEMI Committee which meets quarterly. This committee includes ED Physicians, Cardiologists, Cath Lab nurses and manager, ED nurses and manager, EMS Services and Administrators, FGH Administration.
-Standardized drug protocols in the Emergency Department at Forrest General Hospital as well as Transferring Facilities are in place so that every patient is treated the same regardless of which ED Physician or Cardiologist is on call. The decreases the time to initiation of therapy.
-Empowering the ED Physician to activate a “Code STEMI” prior to speaking with the Cardiologist and activating the “Code STEMI” by one burst page which activates the Cath Lab team, Interventional Cardiologist, Nursing Supervisor, and CCU.
-Data collection through the ACC Action/GWTG Registry for quality control and analysis. We received the Silver Award from ACC/NCDR as well as the AHA for meeting standards for all four quarters of 2012.
-We have ongoing relationships with all transferring facilities. We receive STEMI patients from 13 different hospitals. We have empowered the ER Physicians in these Transferring Facilities to activate “Code STEMI’s” as well.
-We now have 12 lead EKG systems in al 40 AAA ambulances. This allows a heart attack to be identified and the “Code STEMI” to be called before the patient even arrives at the hospital. This has been critical in us meeting the First Medical Contact to balloon standards.
-We participate and hold leadership positions within the Mississippi Healthcare Alliance. This Alliance is comprised of the 19 “PCI” Hospitals within the state of Mississippi. We are the second state in the nation to develop a state-wide STEMI system of care. Here at Forrest General Hospital, we are not only a part of the system, but are leading out in the efforts to improve care for heart attack patients.
In 2010 our goal was to reduce morbidity and mortality from ST Elevation Myocardial Infarction and one day be able to make the claim that the Pine Belt is “The Safest Place in Mississippi to have a Heart Attack.” It is clear that the Forrest General Hospital STEMI System can confidently make that claim.