The time it takes from the moment a heart attack starts to the delivery of definitive treatment is a determining factor in a patient's ability to survive. The American Heart Association, the leading voluntary health organization devoted to a world of longer, healthier lives for all, today issued public policy guidance to address systems changes for patients with the most severe type of heart attack.
The policy statement, "Systems of Care for ST-Segment-Elevation Myocardial Infarction (STEMI)," published today in the Association's flagship journalCirculation, sets forth recommendations for how the ideal cardiac system of care should be designed and implemented to ensure that patients with STEMI receive the best evidence-based care at each stage in their illness.
Improvements in cardiac systems of care are necessary to ensure scientific advances in the treatment and care of patients to improve patient outcomes. The policy statement comes as STEMI systems of care have seen significant improvement resulting from the American Heart Association's Mission: Lifeline program, a national initiative to advance systems of care for patients with STEMI and other acute disease states. Since Mission: Lifeline was established in 2007, it has significantly increased timely access to percutaneous coronary intervention for patients with STEMI, resulting in declining morbidity and mortality rates and increased research that has improved understanding of effective STEMI systems of care.
However, significant barriers and opportunities remain that require changes and improvements in public policy.
“我们可以从最严重的听到拯救更多的生命t attacks, and we know the policy changes that will allow us to do so," said Alice Jacobs, M.D., FAHA, the statement's lead author and vice chair for clinical affairs in the Department of Medicine at Boston University Medical Center. "From ensuring patients suffering a heart attack can access 9-1-1 emergency services, to guaranteeing they receive needed services including EMS triage and post-acute care, policy solutions can improve the efficiency of care protocols and save time at critical junctures to ensure every STEMI patient has the best chance of survival."
Fully 85% of the U.S. population lives within reach of a STEMI system of care.[1] However, 40% of patients do not call 9-1-1 and instead go to their local emergency department.[2],[3] This can delay life-saving medical intervention by more than 30 minutes on average, decreasing the ability of coordinated response and care across all intervention teams and increasing the likelihood of acute heart failure or cardiac arrest.[4] Studies show that although 41% of patients arriving at the emergency room with chest pain/angina-equivalent symptoms receive an echocardiogram (ECG) within 10 minutes, women experience significant delays (nearly 20 minutes longer than for men). Regional STEMI systems perform better at decreasing sex and age disparities.[5],[6],[7]
"It takes our health care system an average of nearly 20 minutes longer to provide women the same emergency cardiac care they provide men. This is unacceptable, at a life-or-death moment," said Jessica Zègre-Hemsey, Ph.D., R.N. statement co-author and associate professor of nursing at the University of North Carolina at Chapel Hill. "Taking the best care of patients requires a strategic policy playbook that ensures everyone on the care delivery team knows how to maximize a patient's chances of survival and reduce health inequities."
The statement's specific policy recommendations include:
This policy statement was prepared by the American Heart Association Advocacy Coordinating Committee.
Co-authors are Alice K. Jacobs, MD, FAHA, Chair; Murtuza J. Ali, MD; Patricia J. Best, MD; Mark C. Bieniarz, MD; Vincent J. Bufalino, MD, FAHA; William J. French, MD; Timothy D. Henry, MD; Lori Hollowell, MHIT, BSN, RN; Edward C. Jauch, MD, MS, FAHA; Michael C. Kurz, MD, MS, FAHA; Michael Levy, MD; Puja Patel, MS, MBA; Travis Spier, RN, MSN, NR-Paramedic, FP-C; R. Harper Stone, MD; Katie L. Tataris, MD, MPH; Randal J. Thomas, MD; and Jessica K. Zègre-Hemsey, PhD, RN. Authors' disclosures are listed in the manuscript.
Story Source:
Materialsprovided byAmerican Heart Association.注:内容可以ited for style and length.
Cite This Page: