Implementation of a Statewide System for Coronary Reperfusion for ST-Segment
Context: Despite two decades of evidence demonstrating benefits from prompt coronary reperfusion, registries continue to show that many patients with ST-segment elevation myocardial infarction (STEMI) are treated too slowly or not at all.
Objective: To establish a statewide system for reperfusion, as exists for trauma care, to overcome systematic barriers.
Design and Setting A quality improvement study that examined the change in speed and rate of coronary reperfusion after system implementation in 5 regions in North Carolina involving 65 hospitals and associated emergency medical systems (10 percutaneous coronary intervention [PCI] hospitals and 55 non-PCI hospitals).
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JAMA. 2007;298(20):2371-2380. Published online November 4, 2007 (doi:10.1001 /jama.298.20.joc70124).