How to Establish a Multi Hospital STEMI Transfer System

Size: px
Start display at page:

Download "How to Establish a Multi Hospital STEMI Transfer System"

Transcription

1 How to Establish a Multi Hospital STEMI Transfer System Dr. Greg Mishkel for the Doctors of Prairie Cardiovascular and in collaboration with our Community & Springfield Hospitals

2 MI: Evolution of care in Central Illinois 1990 s early adoption/promotion of iv thrombolyis = drip & ship 2000 adoption of mechanical reperfusion 2002: Establish Institutional processes for acute MI care 2005: DANAMI/PRAGUE/MHI model: Inter-hospital transfer to TWO Springfield hospitals (St. John s Hospital, Memorial Medical Center) = PRAIRIE STAT HEART PROGRAM Barriers Barriers to to PPCI PPCI STEMI STEMI Care Care in in Central Central Illinois Illinois Limited Limited facilities facilities Long Long inter-hospital travel travel distances Limited Limited ACLS ACLS EMS EMS accessibility accessibility Variability Variability in in ED ED services services (locum (locum tenens) tenens)

3

4 2005: 6 Referral Centers Mean Transfer Distance: 46 miles (range:28-88) 4: Helicopter, 2: Ambulance 2009

5 So how was this done? Physician leadership, physician buy in Full time co ordinator/facilitator (communications, logistics, deal with SNAFU s, educational events) Hospital commitment (funding, quality, cath lab personnel) Establish effective high quality ER STEMI program Establish lines of communication (ER switchboard cath lab) Treatment guidelines Monitor outcomes, modify procedures Reduce readmissions Build on success of local program to entice outside programs to be part of the team Regular (annual?) of all participants (we include the switchboard operators) in educational forums/updates to share results/successes/challenges

6 What do all of these first 3 requirements have in common PEOPLE NOT STRUCTURES Dofasco Steel my first summer job in Hamilton, Ontario Our product is Steel Our Strength is People

7 So how was this done? Physician leadership, physician buy in Full time co ordinator/facilitator (communications, logistics, deal with SNAFU s, educational events) Hospital commitment (funding, quality, cath lab personnel) Establish effective high quality ER STEMI program (St. John s * 90) Establish lines of communication (ER switchboard cath lab) Treatment guidelines Monitor outcomes, modify procedures Reduce readmissions Build on success of local program to entice outside programs to be part of the team Regular (annual?) of all participants (we include the switchboard operators) in educational forums/updates to share results/successes/challenges

8 STEMI: Where We Started at our hospital Doing well: performing above the average hospital for STEMI care in Crusade and NRMI registries, but wanted to be exceptional Formation of AMI Team in 2003 to target performance above the top 10% of Crusade/Action registry hospitals Formal Intervention started late 2003/early 2004 Obstacles to performance improvement included distance of new ED from cath lab, lack of standardized protocols and medical record documentation.

9 AMI Team Strategic Goals Achieve D2B time of <90 minutes for 100% of STEMI patients Implement standardized, evidence based and guideline driven pathways of care to improve quality Achieve 100% compliance with admission and discharge medications for all AMI patients Achieve results above the top 10% of Action registry hospitals for STEMI care EKG done within 5 minutes for patients with chest pain ED Door to cath lab arrival of < 30 minutes Cath Lab arrival to balloon dilatation of < 25 minutes Implement pre hospital ECG

10 Methods Formation of a multidisciplinary AMI team with quarterly meetings in Fall of 2003 ED meds bundled ASA, Beta Blocker, Heparin, and Nitroglycerin ED physician empowered to concurrently activate cardiologist and cath lab team upon diagnosis of STEMI with STAR 90 page Cardiologist meets and evaluates patient in cath lab, not ED Accountability and tracking form following patient through process allowing evaluation of performance of various phases of the D2B process Implementation of guideline driven treatment protocol and procedural protocol Weekday night team resides in hospital Benchmarking of performance with other centers using Action and MIDAS registries.

11 AMI Team Dr. Charles Lucore, Chairman, Department of Cardiology Dr. Linda Nordeman, Chairman, Department of Emergency Medicine Dr. Greg Mishkel and Frank Mikell, PCCL Dr. John Nester, Springfield Clinic Dr. John Byrnes, Emergency Room Cardiac Catheterization Lab Representatives: Sheryl Friedrich et al Emergency Department Representatives: Amy Jones et al Cardiac Nursing Representatives: Jennifer Cullen et al Quality Resource Management Representatives: Diane Tebrugge et al Health Information Management Representatives: Heather Shankland et al

12

13

14 AMI Door to Cath Lab Tracking Sheet To be completed only for ST elevation and/or LBBB on 1 st 12 lead EKG patients Arrival Time EKG Time Tech Time Cardiologist paged ED Physician Time Cardiologist returns page Cardiologist Cath Lab notified Cath lab responds Pt prepared for cath lab ED Nurse Time Cath Lab calls for patient Pt leaves ED Cath lab arrival time Balloon inflation time Complications that may delay process (pt requires intubation, pt arrests, or requires additional stabilization, atypical presentation)

15

16 100 Acute Myocardial Infarction Discharge Medications 2003 May 2009 (Data from NRMI 4, Action, MIDAS Comparative Performance System (CPMS)) ACE #s do not always screen for LVEF < 40% from NRMI report Aspirin Beta Blocker Ace Inhibitor Statin/lipid ASA 99% Beta Blocker 98% Ace/ARB 97% Statin 99% Top 10% (Action STEMI rpt) ASA 100% Beta Blocker 99% Ace/ARB 95% Statin 97%

17

18 STEMI Myocardial Infarction In-Hospital Events (last 12 months) St. John s National Avg. Top 10% Death Rate (%) 2.8% 5.9% 5.8% Door to Balloon Time (minutes) Bleeding Requiring Transfusion (%) 2.3% 6.3% 7.4% Stroke 0.60% 0.80% 0.60% Length of Stay (days) Source: 2 nd Qtr 08-1 st Qtr 2009 ACTION Registry (Get With the Guidelines) Gold Performance Achievement Award for 2009

19 So how was this done? Physician leadership, physician buy in Full time co ordinator (communications, logistics, deal with SNAFU s, educational events) Hospital commitment (funding, quality, cath lab personnel) Establish effective high quality ER STEMI program Establish lines of communication (ER switchboard cath lab) Treatment guidelines Monitor outcomes, modify procedures Reduce readmissions Build on success of local program to entice outside programs to be part of the team Devise (based on local needs) an integrated/consistent one call, one protocol Regular (annual?) of all participants (we include the switchboard operators) in educational forums/updates to share results/successes/challenges

20 Global Components of Process of Transfer STEMI Care Community Facility Transport Tertiary Facility Door In-Door Out Departure-Door 2 Door 2-Balloon ECG Decision Treatment Initiate STAT Heart Arrange Transfer Transfer Air Ambulance Cath Lab Arrival Diagnostic Cath PCI Ideal Goal: <30 minutes <30 minutes <30 minutes Goal: Door-Balloon: 90 min.

21 3-5 min Suspected MI (Step1) 12 Lead ECG/STEMI Identified (Step 2) Determine Bleeding Risk (Step 3) 5-10 min Activate Stat Heart Team Call for quickest available transport (Step 4) Ambulance/Helicopter Call Springfield Hospital Activate Stat Heart Team min Community Stat Heart Team ED MD 2-RN Ancillary staff 30 minute Transport time Available PCI Protocol Air/Ground Transport Low Bleeding Risk 30 minute Transport time NOT Available Thrombolytic Protocol Air/Ground Transport High Bleeding Risk Contraindication Protocol Air/Ground Transport Springfield Stat Heart Team Cardiologist Coordinator Cath Lab Security Admitting Administrative Rep ER contact Goal: Out the Door in < 30 minutes

22 Prairie Stat Heart Protocols Lisa Page, RN

23 Goal out the door in 30 minutes or less 0-3 minutes Patient presents with chest pain or associated symptoms TREAT ALL patients as potential Stat Heart until deemed otherwise 3-5 minutes ECG done ECG to ED physician for quick diagnosis. ED physician determines if STAT Heart criteria is met minutes Activate STAT Heart team at community hospital (staff pre-assigned duties) First call -staff calls quickest transport air or ground (base on mileage between hospitals) Second call Springfield Hospital receiving pt. Stat Heart team activated in Springfield. Automatic - accepting Prairie cardiologist and bed assigned.

24 12-20 minutes Nurses start IV s & give standard meds (ASA, Lopressor, NTG) Physician determines if patient is high bleeding risk (contraindication questions) Transport time < 30 min. helicopter/ambulance - PCI protocol Transport time > 30 min. helicopter/ambulance - Thrombolytic protocol Helicopter or ambulance transfer - Contraindication protocol if pt. is high risk for bleeding (80 yrs or older, on Coumadin etc.) Give protocol meds minutes EMS transport arrives, packages pt., brief report (transport team is educated on process) Departure Call receiving Springfield Hospital with departure page

25 So how was this done? Physician leadership, physician buy in Full time co ordinator (communications, logistics, deal with SNAFU s, educational events) Hospital commitment (funding, quality, cath lab personnel) Establish effective high quality ER STEMI program Establish lines of communication (ER switchboard cath lab) Treatment guidelines Monitor outcomes, modify procedures Reduce readmissions Build on success of local program to entice outside programs to be part of the team Devise (based on local needs) an integrated/consistent one call, one protocol Regular (annual?) of all participants (we include the switchboard operators) in educational forums/updates to share results/successes/challenges

26

27 SO HOW ARE WE DOING? STAT Heart Population: N approx. 600

28 Comparison Of STEMI Process of Care For Inter hospital Transfer: Door Balloon Times 0 % PTS NRMI 3/4 NCDR (n=4278) 2006 < 90 min. < 120 min Stat Heart- Spr Stat Heart- Carb Total Stat Heart (n=15,049) (n=338) (n=44) (n=382)

29 In Hospital Clinical Outcomes Length of hospitalization (mean ± SD days): 3.6 ± 2.5 vs. 5 ± 6.3; p=0.0001

30 Comparison Of 30 day Clinical Outcomes NRMI vs. Stat Heart: Springfield Hub % PTS 10 Meta-analysis Stat Heart/07 Stat Heart 8/08 (n=1472) (n=188) Death Non-Shock Death Re-infarction Stroke Composite

31 PROCEDURAL KEYS to Success 1. EARLY RECOGNITION OF MI starts the interventional cascade beginning with QUICK call to helicopter or ambulance for transport 2. A SINGLE call to activate Stat Heart Process in Springfield 3. Standardized Protocol/ Orders (PCC and ED physician agree to adhere to standard orders as written) 4. Standardized communications via pager identifies MI, patient departure, 15 minute arrival 5. Cath lab nurse calls after receiving departure page for brief report-cath lab nurse calls community hospital nurse. Cardiologist and team awaits arrival in cath lab. 6. Communication ON-GOING throughout the process from beginning to end 7. Rapid transportation via ground or air is mandatory. Regular meetings with these providers 8. Education provided to all Stat Heart team members 9. Data collection to promote process improvement and quality 10. Feedback and reports given promptly (immediately after each case) 11. Public education (regarding Sx of MI, program in their area) 12. Debrief with Stat Heart team members at regular intervals and especially after failures (problems compound with out intervention) 13. No Blame Environment! 14. Continue to innovate. Don t tolerate failure, don t rest on success (EKG s in the field, paramedic education, earlier initiation of Rx) 15. D2B time is important, but it s LIVES SAVED THAT REALLY COUNTS. Mortality reflects the proof in the pudding

32 Conclusions Stat Heart (Rural Inter-Hospital Transfer) Regional STEMI Program: feasible/safe with reproducible, favorable and comparable process measure outcomes to to U.S. Registry, despite program growth among broad range of of hospital systems. Between , the utilization of of this coordinated, rural inter-hospital STEMI transfer program, appears to to associated with shorter hospitalization and improved inhospital clinical outcomes, as as compared to to non- standardized pre-stat Heart STEMI care. in-

33 Conclusions Stat Heart (Rural Inter-Hospital Transfer) Improvements -- Procedural Time (wide inter-procedural/inter-operator variability) -- Standardization of of cardiac cath cath lab lab process -- Implementation of of pre-hospital ECG: Reduce door-in/door-out time time Emphasis on on program maintenance and and improvement -- Avoid complacency (delays): meetings, updates, teamwork (transport, ED s, ancillary staff, cath cath lab, lab, administration, etc) etc) -- Program-wide commitment to to collection, interpretation and and dissemination of of data data -- Nimble program: modifiable process/treatment changes RN RN Coordinator: Education, education, education!!

34 Minneapolis Heart Institute Timothy D. Henry, MD, FACC

35 EMS COMPONENTS OF A SYSTEM 1. PREHOSPITAL 2. TRIAGE 3. TRANSFER Non PCI Capable Only 50% of STEMI use EMS in the US 10% Pre-hosp ECG PCI Capable

36 Primary PCI: Access 42.0% PCI hospital is closest facility 79.0% within 60 minute prehospital time Nallamothu et al. Circulation 2006;113:1189

37 Red Zone II ( mins) Blue Zone I (< 90 mins) Zone1 Protocol Aspirin 325 mg Clopidogrel 600mg UFH Beta-blocker PCI

38 Protocol focus: Simple Fast Reduce variability Red Zone II ( mins) Blue Zone I (< 90 mins) Zone 2 Protocol Aspirin 325 mg Clopidogrel 600mg UFH TNK ½ dose Beta-blocker PCI

39 MHI Level 1 MI: Door Balloon Times % of patients ANW Zone 1 Zone 2 NRMI 3/4 < 90 mins <120mins

40 Kaplan-Meier Survival Curve Survival Probability ANW Zone 1 Zone 2 p = Days

41 Level 1 Heart Attack System Sioux Falls

42 A national quality improvement effort led by the ACC and IHI which aims to reduce 30 day, all cause re admission rates for patients discharged with cardiac conditions. Enroll now to participate in the October 22 nd kick off webinar! Please visit or for more information

Two Hospitals-One Heart: World Class Heart Care through Multi-Disciplinary Collaboration

Two Hospitals-One Heart: World Class Heart Care through Multi-Disciplinary Collaboration Two Hospitals-One Heart: World Class Heart Care through Multi-Disciplinary Collaboration American Nurses Association Susie Schnitker RN, BSN, CEN 7 th Annual Nursing Quality Conference Director of Critical

More information

STEMI ALERT! Craig M. Hudak, MD, FACC,FACP 24 January 2015

STEMI ALERT! Craig M. Hudak, MD, FACC,FACP 24 January 2015 STEMI ALERT! Craig M. Hudak, MD, FACC,FACP 24 January 2015 STEMI Overview ST segment Elevated Myocardial Infarction Patient Outcome Goals: Save myocardium Reduce CHF Reduce arrhythmias Improve quality

More information

Duke Life Flight. Systems of Care for Time Dependent Emergencies. Disclosures. Disclosures 9/19/2017

Duke Life Flight. Systems of Care for Time Dependent Emergencies. Disclosures. Disclosures 9/19/2017 Duke Life Flight Systems of Care for Time Dependent Emergencies Claire M Corbett, MMS, NRP Manager of Neurodiagnostics and Stroke Center New Hanover Regional Medical Center Wilmington, NC Disclosures Clinical

More information

STEMI SYSTEM RECEIVING CENTER STANDARDS AND DESIGNATION

STEMI SYSTEM RECEIVING CENTER STANDARDS AND DESIGNATION POLICY NO: FAC - 9 DATE ISSUED: 11/2016 DATE TO BE REVIEWED: 11/2019 STEMI SYSTEM RECEIVING CENTER STANDARDS AND DESIGNATION Purpose: To define the criteria for designation as a STEMI Receiving Center

More information

The STEMI ALERT Packet

The STEMI ALERT Packet The STEMI ALERT Packet (At a PCI-capable institution) Use of a STEMI ALERT Packet is a key step in optimizing treatment of the STEMI patient. Opening a STEMI ALERT Packet upon first recognition of STEMI

More information

Contra Costa County Emergency Medical Services. STEMI System Performance Report

Contra Costa County Emergency Medical Services. STEMI System Performance Report Contra Costa County Emergency Medical Services STEMI System Performance Report Quarter III 2009 Contra Costa Emergency Medical Services STEMI System Performance Executive Report: Quarter III, 2009 Advisory

More information

Washington State Emergency Cardiac & Stroke System of Care. Sample proof of concept Report Cardiac Measures

Washington State Emergency Cardiac & Stroke System of Care. Sample proof of concept Report Cardiac Measures Washington State Emergency Cardiac & Stroke System of Care Sample proof of concept Report Cardiac Measures COAP IN 2011 COAP IN 2011 Washington State Emergency Cardiac & Stroke CLICK TO EDIT MASTER TITLE

More information

Multidisciplinary Process Improvement Building Relationships

Multidisciplinary Process Improvement Building Relationships Multidisciplinary Process Improvement Building Relationships Mission: Lifeline - Relationships Improved Outcomes Presented by: Lori Hollowell, BSN, RN National Quality Systems Improvement Consultant, Mission:

More information

Implementing & Improving Upon A STEMI System

Implementing & Improving Upon A STEMI System 2 Implementing & Improving Upon A STEMI System Dipti Itchhaporia, MD, FACC, FESC Trustee, American College of Cardiology Assistant Clinical Professor, University of California, Irvine Robert and Georgia

More information

Caring for the STEMI Patient:

Caring for the STEMI Patient: Caring for the STEMI Patient: Primary PCI and Other Considerations John M Gallagher, MD EMS System Medical Director Wichita/Sedgwick County Kansas Conflicts: None but looking Disclosures: Chairman of the

More information

STEMI RECEIVING CENTER

STEMI RECEIVING CENTER Monterey County EMS System Policy Policy Number: 5150 Effective Date: 5/1/2012 Review Date: 12/31/2016 STEMI RECEIVING CENTER I. PURPOSE To define requirements for designation as a Monterey County STEMI

More information

Contra Costa County Emergency Medical Services. STEMI System Performance Report

Contra Costa County Emergency Medical Services. STEMI System Performance Report Contra Costa County Emergency Medical Services STEMI System Performance Report Quarter 4, 2009 & Year to Date 2009 Contra Costa Emergency Medical Services STEMI System Performance Executive Report: Quarter

More information

EP15: Describe and demonstrate interdisciplinary collaboration using continuous quality and process improvement.

EP15: Describe and demonstrate interdisciplinary collaboration using continuous quality and process improvement. 1 EP15: Describe and demonstrate interdisciplinary collaboration using continuous quality and process improvement. Interdisciplinary collaboration is an essential component of Riverside Medical Center

More information

SIMPLE SOLUTIONS. BIG IMPACT.

SIMPLE SOLUTIONS. BIG IMPACT. SIMPLE SOLUTIONS. BIG IMPACT. SIMPLE SOLUTIONS. BIG IMPACT. QUALITY IMPROVEMENT FOR INSTITUTIONS combines the American College of Cardiology s (ACC) proven quality improvement service solutions and its

More information

Integrating EMS into Rural Systems of Care. John A. Gale, MS National Conference of State Flex Programs July 24, 2013

Integrating EMS into Rural Systems of Care. John A. Gale, MS National Conference of State Flex Programs July 24, 2013 Integrating EMS into Rural Systems of Care John A. Gale, MS National Conference of State Flex Programs July 24, 2013 Contact Information John A. Gale, M.S., Research Associate Maine Rural Health Research

More information

San Joaquin County Emergency Medical Services Agency

San Joaquin County Emergency Medical Services Agency San Joaquin County Emergency Medical Services Agency http://www.sjgov.org/ems DATE: Mailing Address PO Box 220 French Camp, CA 95231 TO: FROM: SUBJ.: All Prehospital Personnel and Providers Emergency Department

More information

Mission: Lifeline Hospital Accreditation Webinar. June 21, :00PM 3:00PM CST

Mission: Lifeline Hospital Accreditation Webinar. June 21, :00PM 3:00PM CST Mission: Lifeline Hospital Accreditation Webinar June 21, 2012 2:00PM 3:00PM CST Speaker Introductions Deb Koeppen, RN Society of Chest Pain Centers Director of Business Development Larry Brown, RN, BSN

More information

PURPOSE: The purpose of this policy is to establish requirements for designation as a STEMI Receiving Center (SRC) in San Joaquin County.

PURPOSE: The purpose of this policy is to establish requirements for designation as a STEMI Receiving Center (SRC) in San Joaquin County. PURPOSE: The purpose of this policy is to establish requirements for designation as a STEMI Receiving Center (SRC) in San Joaquin County. AUTHORITY: Health and Safety Code, Division 2.5, Sections 1797.67,

More information

NCDR 13 Annual Conference. ACTION Registry-GWTG Workshop #1. Disclosures Dr. Fonarow, MD, FACC, FAHA. Objectives 2/28/2013.

NCDR 13 Annual Conference. ACTION Registry-GWTG Workshop #1. Disclosures Dr. Fonarow, MD, FACC, FAHA. Objectives 2/28/2013. NCDR 13 Annual Conference ACTION Registry-GWTG Workshop #1 Disclosures Dr. Fonarow, MD, FACC, FAHA Boston Scientific, Takeda, Amgen, Johnson&Johnson, Medtronic, Gambro, NIH/NIAID, Novartis, NHLBI Kim Hustler

More information

Mission: Lifeline and GWTG-CAD (Coronary Artery Disease)

Mission: Lifeline and GWTG-CAD (Coronary Artery Disease) Mission: Lifeline and GWTG-CAD (Coronary Artery Disease) Gary Myers Sr. Quality and Systems Improvement Director & EMS Consultant American Heart Association Sioux Falls, SD I have no actual or potential

More information

Improving Clinical Outcomes The Case for Electronic ED Door to EKG Time Monitoring

Improving Clinical Outcomes The Case for Electronic ED Door to EKG Time Monitoring Improving Clinical Outcomes The Case for Electronic ED Door to EKG Time Monitoring 2014 Distinguished Achievement Award for Clinical Excellence TM Competition October 22, 2014 St. Dominic-Jackson Memorial

More information

Aligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model. Rome H. Walker MD February 28, 2008

Aligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model. Rome H. Walker MD February 28, 2008 Aligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model Rome H. Walker MD February 28, 2008 A Concerted Effort Because the rewards are based on shared performance, the program is intended to create

More information

Acceleration for ACS. NSTEMI Event 09 November. Outputs from Table Discussions

Acceleration for ACS. NSTEMI Event 09 November. Outputs from Table Discussions Acceleration for ACS NSTEMI Event 09 November Outputs from Table Discussions 1 1. What mechanism do we need to have to identify patients early (within 6 hours of admission to hospital)? Have identification

More information

PRIMARY PERCUTANEOUS CORONARY INTERVENTION (PPCI) PROTOCOL

PRIMARY PERCUTANEOUS CORONARY INTERVENTION (PPCI) PROTOCOL PRIMARY PERCUTANEOUS CORONARY INTERVENTION (PPCI) PROTOCOL EXTRACT FOR USE BY NORTH WEST AMBULANCE SERVICE PARAMEDICS Revised April 2013 Liverpool Heart and Chest Hospital Aintree University Hospital Countess

More information

Ambulance Operations Procedure Appropriate Hospital Access for ST Elevation Myocardial Infarction Patients. National Ambulance Service (NAS)

Ambulance Operations Procedure Appropriate Hospital Access for ST Elevation Myocardial Infarction Patients. National Ambulance Service (NAS) Ambulance Operations Procedure Appropriate Hospital Access for ST Elevation Myocardial Infarction Patients National Ambulance Service (NAS) Document reference number Revision number Approval date NASCG017

More information

Region III STEMI Plan

Region III STEMI Plan Region III STEMI Plan I. Plan Goals A. To develop a Region III STEMI System that when implemented, will result in decreased mortality and morbidity in the MIEMSS Region III. In order to accomplish this,

More information

2018 Mission: Lifeline EMS Detailed Recognition Criteria, Achievement Measures and Reporting Measures

2018 Mission: Lifeline EMS Detailed Recognition Criteria, Achievement Measures and Reporting Measures 2018 Mission: Lifeline EMS Detailed Recognition Criteria, Achievement Measures and Reporting Measures Table of Contents Mission: Lifeline EMS Recognition Award Levels Page 2 Mission: Lifeline EMS Recognition

More information

EMS Engagement Communication Tools and Strategies for Coordinating Patient Care

EMS Engagement Communication Tools and Strategies for Coordinating Patient Care EMS Engagement Communication Tools and Strategies for Coordinating Patient Care Presenters Orlando Rivera, MSN, RN, EMT-P ACS Program Coordinator Lehigh Valley Health Network Chris Greb, NRP Operations

More information

STEMI Receiving Center Designation Process

STEMI Receiving Center Designation Process PURPOSE STEMI Receiving Center Designation Process Rev. 2-6-2013 To define requirements for designation of a hospital as a ST-elevation myocardial infarction (STEMI) receiving center for the Austin-Travis

More information

Southwest Texas Regional Advisory Council Regional Percutaneous Coronary Intervention Facility & EMS Heart Alert Agencies

Southwest Texas Regional Advisory Council Regional Percutaneous Coronary Intervention Facility & EMS Heart Alert Agencies Southwest Texas Regional Advisory Council Regional Percutaneous Coronary Intervention Facility & EMS Heart Alert Agencies LETTER OF ATTESTATION August, 2015 BACKGROUND The Southwest Regional Advisory Council

More information

Objective Measurement

Objective Measurement STEMI Designation Contract HOSPITAL SERVICES A. Current license to provide Basic Emergency Services in Contra Costa County Copy of License B. Cardiac Catheterization Laboratory services Copy of License.

More information

1/9/2017. Systems of Care in EMS: An Integrated System of Cardiac Care. Describe systems-based response to time-sensitive clinical conditions

1/9/2017. Systems of Care in EMS: An Integrated System of Cardiac Care. Describe systems-based response to time-sensitive clinical conditions Systems of Care in EMS: An Integrated System of Cardiac Care NAEMSP Medical Director s Course January 23, 2017 Jefferson Williams, MD, MPH, FACEP Deputy Medical Director Wake County EMS System Clinical

More information

STEMI System of Care Policy

STEMI System of Care Policy County of Kern Emergency Medical Services STEMI System of Care Policy Ross Elliott EMS Director Robert Barnes, M.D. Medical Director 1 TABLE OF CONTENTS PURPOSE... 2 AUTHORITY... 2 DEFINITIONS... 2 DESIGNATION...

More information

American College of Cardiology Patient Navigator Program Focus MI National PROGRAM REQUIREMENTS

American College of Cardiology Patient Navigator Program Focus MI National PROGRAM REQUIREMENTS American College of Cardiology Patient Navigator Program Focus MI National 1. Participant Responsibilities PROGRAM REQUIREMENTS 1.1. Program Management 1.1.1. Upon opting-in to the Patient Navigator Program

More information

Buchanan, 1996; Knaus, Felton, Burton, Fobes, & Davis 1997, J. of Nsg Administration

Buchanan, 1996; Knaus, Felton, Burton, Fobes, & Davis 1997, J. of Nsg Administration Can Patients with Moderate to High Risk Acute Coronary Syndromes Be Cared For safely in a Cardiac Acute Care Unit (ACU) Introduction Several studies have evaluated the safety of managing g patient with

More information

Intermediate Coronary Care Unit Rotation

Intermediate Coronary Care Unit Rotation 1 Intermediate Coronary Care Unit Rotation Section of Cardiology Dartmouth-Hitchcock Medical Center (2008-2009) I. Overview of Rotation The cardiology-specific critical care experience is in the Intermediate

More information

Redesigning the Acute Coronary Syndrome (NSTE- ACS) pathway at Morriston Cardiac Centre - The case for change

Redesigning the Acute Coronary Syndrome (NSTE- ACS) pathway at Morriston Cardiac Centre - The case for change Redesigning the Acute Coronary Syndrome (NSTE- ACS) pathway at Morriston Cardiac Centre - The case for change 4 th July 2012 Dr D Smith & Dr S Dorman Introduction... 2 NSTE-ACS Where are we now?... 2 NSTE-ACS

More information

Birmingham Regional EMS System STEMI System Plan

Birmingham Regional EMS System STEMI System Plan Attachment 4 Birmingham Regional EMS System STEMI System Plan \\bremssdc\stafffiles\frontdesk\stemi\plan\stemi Plan for MDAP 2.9.10.doc - 1 - TABLE OF CONTENTS Rationale....3 Goals...3 Overview...4 Components

More information

MEMORANDUM OF UNDERSTANDING

MEMORANDUM OF UNDERSTANDING THIS MEMORANDUM OF UNDERSTANDING (this Agreement ) is made by and among the American Heart Association ( AHA ) and each of the Emergency Medical Service agencies ( EMS agencies ) and hospitals ( Hospital

More information

Presenter Disclosure

Presenter Disclosure Improving Transitions from the Hospital to Community Settings IHI National Forum Learning Lab Sunday, December 9, 2012 Session L20 Presenter Disclosure Leora Horwitz, MD Assistant Professor of medicine

More information

The Use Of Guidelines And Clinical Pathways

The Use Of Guidelines And Clinical Pathways The Use Of Guidelines And Clinical Pathways Quality & Safety In Healthcare First Congress Lebanese Society for Quality & Safety in Healthcare 15-16 November 2013 Ashraf Ismail, MD, MPH, CPHQ Managing Director,

More information

QI and DUE in Pharmacy Practice

QI and DUE in Pharmacy Practice Pharmacy 483: QI and DUE in Pharmacy Practice Steve Riddle, BS Pharm, BCPS QI and Medication Utilization Lead HMC Pharmacy February 24, 2004 Acute Myocardial Infarction HA, 52yo male admitted via ER with

More information

TIME CRITICAL DIAGNOSIS SYSTEM

TIME CRITICAL DIAGNOSIS SYSTEM TIME CRITICAL DIAGNOSIS SYSTEM Recommendations to Advance Emergency Medical Care for Stroke and STEMI in Missouri Time Critical Diagnosis System Task Force for Stroke and STEMI August 2008 online version

More information

HEART INVESTIGATION UNIT

HEART INVESTIGATION UNIT HEART INVESTIGATION UNIT HAMILTON HEALTH SCIENCES (GENERAL SITE) INFORMATION HANDBOOK (Updated: July 2011) 1 TRIAGE GUIDELINES ADMITTED PATIENTS FROM ANY OF OUR REFERRING HOSPITALS Goal: to complete procedures

More information

The Medicare Beneficiary Quality Improvement Project (MBQIP) Monthly Performance Improvement Call

The Medicare Beneficiary Quality Improvement Project (MBQIP) Monthly Performance Improvement Call The Medicare Beneficiary Quality Improvement Project (MBQIP) Monthly Performance Improvement Call April 16, 2015 Amber Theel, Executive Director Patient Safety Susan Rivera-Lee, WSHA Consultant MBQIP MBQIP

More information

Preventing Heart Failure Readmissions by Using a Risk Stratification Tool

Preventing Heart Failure Readmissions by Using a Risk Stratification Tool Preventing Heart Failure Readmissions by Using a Risk Stratification Tool Anna Dermenchyan, MSN, RN, CCRN-K Senior Clinical Quality Specialist Department of Medicine, UCLA Health PhD Student, UCLA School

More information

MOC Part IV: Your Guide to Making it Happen.

MOC Part IV: Your Guide to Making it Happen. MOC Part IV: Your Guide to Making it Happen. Joseph P. Drozda, Jr., MD, F.A.C.C. Mercy, MO Paul D. Varosy, MD, F.A.C.C., FAHA, FHRS University of Colorado Denver School of Medicine, CO Disclosures Course

More information

Benefits of Tele-ICU Management of ICU Boarders in the Emergency Department

Benefits of Tele-ICU Management of ICU Boarders in the Emergency Department Benefits of Tele-ICU Management of ICU Boarders in the Emergency Department Session #309, February 22, 2017 Michael Ries, MD, MBA, FCCM, FCCP, FACP Medical Director Adult Critical Care and eicu Advocate

More information

Polling Question. Polling Question. Taking Education to the Healthcare Team In-situ Simulation in Acute MI Care as a Model for Team-focused CME

Polling Question. Polling Question. Taking Education to the Healthcare Team In-situ Simulation in Acute MI Care as a Model for Team-focused CME Polling Question How many people are participating in this webinar at your location today? Just me! 7 2 8 3 9 4 10 5 More than 10 6 Polling Question What member section do you belong to? Health Care Education

More information

Stroke System-of- Care Plan. Mississippi State Department of Health

Stroke System-of- Care Plan. Mississippi State Department of Health Stroke System-of- Care Plan Mississippi State Department of Health Bureau of Acute Care Systems MSDH Board of Health Approved: October 14, 2015 Revised July 6, 2015 Stroke System-of-Care Plan Table of

More information

W. Douglas Weaver, MD, MACC. American College of Cardiology SENATE FINANCE COMMITTEE

W. Douglas Weaver, MD, MACC. American College of Cardiology SENATE FINANCE COMMITTEE Statement of W. Douglas Weaver, MD, MACC On behalf of the American College of Cardiology Presented to the SENATE FINANCE COMMITTEE Roundtable on Medicare Physician Payments: Perspectives from Physicians

More information

Using Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity

Using Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity Using Clinical Criteria for Evaluating Short Stays and Beyond Georgeann Edford, RN, MBA, CCS-P The Clinical Face of Medical Necessity 1 The Documentation Faces of Medical Necessity ç3 Setting the Stage

More information

Clinical Resource Manual For The Protocol On Iabp

Clinical Resource Manual For The Protocol On Iabp Clinical Resource Manual For The Protocol On Iabp perinatal or IABP transports) must follow the criteria listed below: 1. 01.10.03 Policies- A policy manual (electronic or hard copy) is available and Important

More information

STEMI System of Care: Where do you fit in?

STEMI System of Care: Where do you fit in? presents STEMI System of Care: Where do you fit in? Saturday, April 16, 2016 8 a.m. - 2 p.m. Fogelson Forum Auditorium 8200 Walnut Hill Lane Dallas, TX 75231 TexasHealth.org/CME CME Presented by Conference

More information

Flex Monitoring Team Briefing Paper No. 29 Developing Regional STEMI Systems of Care: A Review of the Evidence and the Role of the Flex Program

Flex Monitoring Team Briefing Paper No. 29 Developing Regional STEMI Systems of Care: A Review of the Evidence and the Role of the Flex Program Flex Monitoring Team Briefing Paper No. 29 Developing Regional STEMI Systems of Care: A Review of the Evidence and the Role of the Flex Program October 2011 With funding from the federal Office of Rural

More information

Oakland County Medical Control Authority System Protocols Transportation Protocol Section Transportation Protocol.

Oakland County Medical Control Authority System Protocols Transportation Protocol Section Transportation Protocol. Purpose: To define the decision-making process to be followed by EMS personnel in order to ensure patients are transported to a facility appropriate for their condition. I. Transportation Procedure A.

More information

EMS System for Metropolitan Oklahoma City and Tulsa 2017 Medical Control Board Treatment Protocols

EMS System for Metropolitan Oklahoma City and Tulsa 2017 Medical Control Board Treatment Protocols PROTOCOL 17A: Adult General Medical s Adult General Medical s Four (4) Levels of General Medical s Priority I and II Priority III No Will time and distance to the hospital of choice be detrimental to the

More information

Nurse Prescribing in Heart Failure (Integrated Service)

Nurse Prescribing in Heart Failure (Integrated Service) Nurse Prescribing in Heart Failure (Integrated Service) Liz Killeen Community Heart Failure CNS & RNP. Galway PCCC. Introduction. Heart Failure affects more than 120,000 Irish people and is one of the

More information

IMPORTANT INFORMATION. Subject: Santa Clara County EMS STEMI Care System - Effective August 4, 2008

IMPORTANT INFORMATION. Subject: Santa Clara County EMS STEMI Care System - Effective August 4, 2008 Emergency Medical Services Agency 645 South Bascom Avenue San Jose, CA 95128 408.885.4250 408.885.3538 fax www.sccemsagency.org July 22, 2008 IMPORTANT INFORMATION To: From: Santa Clara County EMS System

More information

Integrated Performance Report

Integrated Performance Report To provide a safe and effective healthcare service to all our communities in the East of England Integrated Performance Report Meeting Date: July 2016 Data: The month of June (May for Clinical & HART)

More information

Developing a successful EP service line / practice

Developing a successful EP service line / practice Developing a successful EP service line / practice Steven J. Kalbfleisch, M.D. Medical Director Electrophysiology Laboratory Ross Heart Hospital Wexner Medical Center The Ohio State University Evolution

More information

Outpatient Quality Reporting Program

Outpatient Quality Reporting Program The Question and Answer Show Moderator: Karen VanBourgondien, BSN, RN Speaker(s): Pam Harris, BSN, RN June 21, 2017 10:00 am Isn't Q2 submission due August 1, 2017? August 1, 2017 deadline is for Quarter

More information

The Impact of Pre Hospital Blood Collection on Time to Laboratory Test Results and Emergency Department Length of Stay

The Impact of Pre Hospital Blood Collection on Time to Laboratory Test Results and Emergency Department Length of Stay The Impact of Pre Hospital Blood Collection on Time to Laboratory Test Results and Emergency Department Length of Stay Improving the Odds on Quality Las Vegas, Nevada January 25 27, 2012 Principal Investigator:

More information

MBQIP Measures Fact Sheets December 2017

MBQIP Measures Fact Sheets December 2017 December 2017 This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1RRH29052, Rural Quality

More information

National Assessment of Clinical Quality Programs. Introduction. National Assessment of Clinical Quality Programs. Demographics

National Assessment of Clinical Quality Programs. Introduction. National Assessment of Clinical Quality Programs. Demographics National Assessment of Clinical Quality Programs Introduction With the support of the NAEMSP Quality Improvement Committee, this study group is interested in understanding the national picture of clinical

More information

Resuscitation Centers of Excellence: Designation Process Rev January 2010

Resuscitation Centers of Excellence: Designation Process Rev January 2010 Resuscitation Centers of Excellence: Designation Process Rev January 2010 The Path to Improved Outcomes from Sudden Cardiac Arrest in the Austin/Travis County Area The concept of regionalized and specialized

More information

East Texas Gulf Coast Regional Trauma Advisory Council Regional Advisory Council - R (RAC-R)

East Texas Gulf Coast Regional Trauma Advisory Council Regional Advisory Council - R (RAC-R) East Texas Gulf Coast Regional Trauma Advisory Council Regional Advisory Council - R (RAC-R) RAC-R proudly supports and serves Jasper, Newton, Hardin, Orange, Liberty, Jefferson, Chambers, Galveston and

More information

Trauma Service Area - B (BRAC) Regional Stroke Plan

Trauma Service Area - B (BRAC) Regional Stroke Plan Trauma Service Area - B (BRAC) Regional Stroke Plan Trauma Service Area- B (BRAC) P.O. Box 53597 Lubbock, TX 79453 806.791.2582 (office) BRAC serves the counties of Bailey, Borden, Castro, Cochran, Cottle,

More information

interventional cardiac facility (see Appendix 2). Notify receiving hospital, as soon as possible of impending arrival of the patient and give ETA.

interventional cardiac facility (see Appendix 2). Notify receiving hospital, as soon as possible of impending arrival of the patient and give ETA. Page 1 of 9 Purpose: To define the decision-making process to be followed by EMS personnel in order to ensure patients are transported to a facility appropriate for their condition. I. Transportation Procedure

More information

Wired to Save Lives: A Virtual Hospital Experience

Wired to Save Lives: A Virtual Hospital Experience Wired to Save Lives: A Virtual Hospital Experience Donald J. Kosiak, MD, MBA, FACEP, CPE Vice President for Medical Development Thursday, March 3 rd -- 11:30am Conflict of Interest Donald Kosiak, MD Has

More information

Early Recognition of In-Hospital Patient Deterioration Outside of The Intensive Care Unit: The Case For Continuous Monitoring

Early Recognition of In-Hospital Patient Deterioration Outside of The Intensive Care Unit: The Case For Continuous Monitoring Early Recognition of In-Hospital Patient Deterioration Outside of The Intensive Care Unit: The Case For Continuous Monitoring Israeli Society of Internal Medicine Meeting July 5, 2013 Eyal Zimlichman MD,

More information

Ambulatory Emergency Care in South Wales

Ambulatory Emergency Care in South Wales Ambulatory Emergency Care in South Wales The Ambulatory Care Score ( Amb Score) Les Ala Consultant Acute Physician Royal Glamorgan Hospital LLantrisant, South Wales ROYAL GLAMORGAN HOSPITAL Format Our

More information

Quality Matters. Quality & Performance Improvement

Quality Matters. Quality & Performance Improvement Quality Matters First, do no harm it s a defining mandate for those who devote their lives to caring for others health. Recent studies have shown, however, that approximately 100,000 patients nationwide

More information

2017 Congestive Heart Failure. Program Evaluation. Our mission is to improve the health and quality of life of our members

2017 Congestive Heart Failure. Program Evaluation. Our mission is to improve the health and quality of life of our members 2017 Congestive Heart Failure Program Evaluation Our mission is to improve the health and quality of life of our members 2017 Congestive Heart Failure Program Evaluation Program Title: Congestive Heart

More information

Utilizing Systems Engineering Methodologies to Enhance Clinical Decision Support

Utilizing Systems Engineering Methodologies to Enhance Clinical Decision Support Utilizing Systems Engineering Methodologies to Enhance Clinical Decision Support Matt Johnson, Katie Schwalm, Linda Bashaw, Robert Chang, and Christopher Petrilli Utilizing Systems Engineering Methodologies

More information

2015 Congestive Heart Failure. Program Evaluation. Our mission is to improve the health and quality of life of our members

2015 Congestive Heart Failure. Program Evaluation. Our mission is to improve the health and quality of life of our members 2015 Congestive Heart Failure Program Evaluation Our mission is to improve the health and quality of life of our members 2015 Congestive Heart Failure Program Evaluation Program Title: Congestive Heart

More information

PSC Certification: What really happens

PSC Certification: What really happens PSC Certification: What really happens Authors: Wendy J. Smith, BS, MA, RES, RCEP, RN, SCRN Christy Franklin, MS, RN, CNRN Julie Fussner, BSN, RN, CPHQ, SCRN Disclosures Wendy J. Smith- I have no actual

More information

FACT SHEET Summary of Acute Myocardial Infarction (AMI) and Heart Failure (HF) Changes for 1/1/12+ Discharges

FACT SHEET Summary of Acute Myocardial Infarction (AMI) and Heart Failure (HF) Changes for 1/1/12+ Discharges FACT SHEET Summary of Acute Myocardial Infarction (AMI) and Heart Failure (HF) Changes for 1/1/12+ Discharges AMI-1, AMI-3, and AMI-5: Submission to the CMS clinical data warehouse is now optional. This

More information

Hospital Compare Quality Measures: 2008 National and Florida Results for Critical Access Hospitals

Hospital Compare Quality Measures: 2008 National and Florida Results for Critical Access Hospitals Hospital Compare Quality Measures: National and Results for Critical Access Hospitals Michelle Casey, MS, Michele Burlew, MS, Ira Moscovice, PhD University of Minnesota Rural Health Research Center Introduction

More information

Regulatory Compliance Update

Regulatory Compliance Update Regulatory Compliance Update Time Critical Diagnosis: Hospitals Can Survive Sarah Willson, BSN, MBA Vice President of Clinical and Regulatory Affairs swillson@mhanet.com Overview This webinar will provide

More information

Improving Quality in EMS

Improving Quality in EMS Improving Quality in EMS Measuring and Improving Your EMS System Robert Swor DO, FACEP Professor, Emergency Medicine Oakland University William Beaumont School of Medicine Objectives Can I Get a QA program?

More information

STROKE INITIATIVE. Sanford Tracy Medical Center. Danette Ronnfeldt, PA-C Jeri Schons, CNO Jean Metcalf, R.PH

STROKE INITIATIVE. Sanford Tracy Medical Center. Danette Ronnfeldt, PA-C Jeri Schons, CNO Jean Metcalf, R.PH STROKE INITIATIVE Sanford Tracy Medical Center Danette Ronnfeldt, PA-C Jeri Schons, CNO Jean Metcalf, R.PH SANFORD TRACY Duluth Twin Cities Tracy Sioux Falls, SD SANFORD TRACY 25 bed Critical Access Hospital

More information

Developing a Hospital Based Resuscitation Program. Nicole Kupchik MN, RN, CCNS, CCRN, PCCN-CSC, CMC & Chris Laux, MSN, RN, ACNS-BC, CCRN, PCCN

Developing a Hospital Based Resuscitation Program. Nicole Kupchik MN, RN, CCNS, CCRN, PCCN-CSC, CMC & Chris Laux, MSN, RN, ACNS-BC, CCRN, PCCN Developing a Hospital Based Resuscitation Program Nicole Kupchik MN, RN, CCNS, CCRN, PCCN-CSC, CMC & Chris Laux, MSN, RN, ACNS-BC, CCRN, PCCN Objectives: Describe components of a high quality collaborative

More information

Contents. Welcome to the Cath Lab P4/5

Contents. Welcome to the Cath Lab P4/5 Contents Welcome to the Cath Lab Preparation Instructions : information to ensure you are ready for your procedure in the Cath Lab, set out for you as questions (Q) and answers (A) How the day will go

More information

Capital District Emergency Services Council CDESC

Capital District Emergency Services Council CDESC Capital District Emergency Services Council CDESC Quarterly Report Quarter 4 With focus on the Emergency Departments of Cobequid Community Health Centre and Hants Community Hospital 1 Introduction Emergency

More information

Presenter Disclosure

Presenter Disclosure Improving Transitions from the Hospital to Community Settings IHI National Forum Learning Lab Sunday, December 8, 2013 Presenter Disclosure MaryAnne Elma, MPH Quality Implementation and Innovations Director

More information

University of South Dakota Vermillion, South Dakota Department of Nursing. Simulation Scenario Complex Patient: Acute MI. Overview

University of South Dakota Vermillion, South Dakota Department of Nursing. Simulation Scenario Complex Patient: Acute MI. Overview Simulation Scenario Complex Patient: Acute MI Overview Title: Acute MI with Dysrhythmias Concept: Complex Patient To cite this reference: Target Group: Second Year Nursing Students Kisner, T. & Warren,

More information

Clinical Program Cost Leadership Improvement

Clinical Program Cost Leadership Improvement Clinical Program Cost Leadership Improvement December 2017 Presbyterian recently developed a rapid-cycle process for integrating sustainable cost and quality improvements within clinical programs. Population

More information

Clinical Operations in a Service Line Model

Clinical Operations in a Service Line Model Clinical Operations in a Service Line Model John D Angelo, MD, FACEP Executive Director & Senior Vice President Sarah Healey Herod, MPH Director, Service Line Development Jill Castaneda Project Manager,

More information

CHF Readmission Initiative. Mary Fischer MSN, CCRN, PCCN, CHFN Cardiology Clinical Nurse Specialist St. Vincent Hospital Indianapolis, Indiana

CHF Readmission Initiative. Mary Fischer MSN, CCRN, PCCN, CHFN Cardiology Clinical Nurse Specialist St. Vincent Hospital Indianapolis, Indiana CHF Readmission Initiative Mary Fischer MSN, CCRN, PCCN, CHFN Cardiology Clinical Nurse Specialist St. Vincent Hospital Indianapolis, Indiana St. Vincent 86 th Street Campus Heart Failure Program History

More information

EXPANDING MENTAL HEALTH SERVICES AND THE BOTTOM LINE

EXPANDING MENTAL HEALTH SERVICES AND THE BOTTOM LINE EXPANDING MENTAL HEALTH SERVICES AND THE BOTTOM LINE Theresa Hyer, Rideout Health Eric Zeller, M.D., CEP America Moderated by Sheree Lowe, California Hospital Association TOPICS FOR TODAY Overview of the

More information

Hospital Outpatient Quality Reporting Program

Hospital Outpatient Quality Reporting Program Hospital Outpatient Quality Reporting Program Support Contractor OQR 2016 Specifications Manual Update Questions & Answers Moderator: Pam Harris, BSN Speakers: Nina Rose, MA Samantha Berns, MSPH Bob Dickerson,

More information

Measured Implementation of an Accelerated Chest Pain Diagnostic Pathway in Rural Practice. Proof of concept

Measured Implementation of an Accelerated Chest Pain Diagnostic Pathway in Rural Practice. Proof of concept Measured Implementation of an Accelerated Chest Pain Diagnostic Pathway in Rural Practice Proof of concept Authors Tim Norman Pinnacle Midlands Health Network Dr Jo Scott Jones - Pinnacle Midlands Health

More information

Lake Health Systems Nurse Reference Guide

Lake Health Systems Nurse Reference Guide Lake Health Systems Nurse Reference Guide Learning Management System - Log onto LMS icon or using the following URL: https://lakehealth.csod.com ADP ipay Statements - You will need to register at: https://ipay.adp.com/ipay/login.jsf

More information

Release Notes 3.3 October 1, Specifications Manual for National Hospital Inpatient Quality Measures

Release Notes 3.3 October 1, Specifications Manual for National Hospital Inpatient Quality Measures October 1, 2010 Guidelines for Using Release Notes Release Notes 3.3 provide modifications to the Specifications Manual for National Hospital Inpatient Quality Measures. The Release Notes are provided

More information

Barriers and Enablers in Chest Pain Guideline Implementation

Barriers and Enablers in Chest Pain Guideline Implementation Workshop on EBM Clinical Practice Guidelines make them work for you GIN EC Community ICEM program (RES 3) Barriers and Enablers in Chest Pain Guideline Implementation Reviewing local barriers and enablers

More information

EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital

EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital EMTALA Talking Points for Patients Who Are Inpatients and Transferring to Another Hospital The movement of a patient from one hospital to another is a transfer (ie: NHRMC to Cherry Hospital, NHRMC to Walter

More information

March 28, 2018 For Decision Board of Directors Item 9.0 Comprehensive Regional Cardiac Program Plan

March 28, 2018 For Decision Board of Directors Item 9.0 Comprehensive Regional Cardiac Program Plan BRIEFING NOTE March 28, 2018 For Decision Board of Directors Item 9.0 Comprehensive Regional Cardiac Program Plan PURPOSE To provide the WWLHIN Board of Directors with a recommendation to endorse the proposed

More information

News SEPTEMBER. Hospital Outpatient Quality Reporting Program. Support Contractor

News SEPTEMBER. Hospital Outpatient Quality Reporting Program. Support Contractor Volume 1, Issue 4 Hospital Outpatient Quality Reporting Program Support Contractor News SEPTEMBER 2011 In This Issue... Emergency Department Arrival and Departure Times Page 2 Hospital OQR Benchmarks Page

More information

Ruchika D. Husa, MD, MS

Ruchika D. Husa, MD, MS Early Response Teams Ruchika D. Husa, MD, MS Assistant Professor of Medicine Division i i of Cardiovascular Medicine i The Ohio State University Wexner Medical Center OBJECTIVES Provide an overview of

More information