使命:生命线®STEMI加速器I和II区域化STEMI护理示范项目
Duke Clinical Research Institute, 与美国心脏协会合作，领导并实施了区域系统加速器I和II项目. These two studies, conducted independent of one another, 重点实施美国心脏协会的使命:生命线计划在人口密集地区和具有复杂组成部分的STEMI护理系统.
ACC/AHA STEMI指南包括一级建议，即“所有社区应建立并维持STEMI护理的区域系统，包括EMS和医院活动的评估和持续质量改进。.“两个加速器项目都试图通过密集实施‘使命:生命线’来实现基于指南的STEMI护理.
| STEMI Accelerator I STEMI Receiving Center Project Participants | STEMI加速器II STEMI接收中心项目参与者 |
| Atlanta, GA | Albany, NY |
| Bakersfield, CA | Cincinnati, OH |
| Colorado (East Range) | Connecticut |
| Columbus, OH | Denver, Colorado |
| Hartford, CT | Eastern Kentucky (Lexington) |
| Hawaii | Houston, TX |
| Houston, TX | Las Vegas, NV |
| Louisville, KY | Little Rock, AK |
| (Northern) New Jersey | New York, NY |
| New York, NY | Portland, OR |
| Philadelphia, PA | Seattle, WA |
| Pittsburgh, PA | Tidewater Region, VA |
| San Antonio, TX | |
| Scranton, PA | |
| St. Louis, MO | |
| Tampa, FL |
| # of Regions | Time Period | # of Patients | # of Hospitals | # of EMS Agencies | |
| STEMI Accelerator I Project | 16 | July 2012 - December 2013 | 23,809 | 484 | 1253 |
| STEMI Accelerator II Project | 12 | April 2015 - March 2017 | 21,160 | 132 | 946 |
任务:生命线STEMI加速器I和II项目计划目标和目的:
- 显著加快区域STEMI护理系统的发展和完善:
- Identifying strong regional systems of care champion(s)
- 组建强大、自我维持的区域特派团:生命线工作队
- Regional diagnostic protocols
- Regional treatment protocols
- Uniform data collection
- Prompt and consistent data feedback
- 以第一加速器项目为基础，及时建立对STEMI紧急护理的区域反应, 协调一致的方式，包括EMS FMC在90分钟内到达设备或在120分钟内到达STEMI转诊医院进行PCI, 对于未接受纤溶治疗并转入PCI的患者.
- 建立紧急心脏护理的区域领导，包括热情和受人尊敬的思想领袖，包括医生, nurses, administrators, 以及代表医院急诊医学的公共卫生官员, cardiology, and EMS. 领导人将就协调照顾的区域解决办法达成共识，并组成一个区域行政领导小组.
- Implement, 通过当地利益相关者组织之间的伙伴关系监督和维护干预, regional AHA leadership and national experts. (Physician leaders of hospitals, EMS agencies, 各地区可通过个别院校之间的合作备忘录(MOC)建立合作伙伴关系, 建立区域质量改进团队的机构和系统.
使命:生命线STEMI加速计划指标/区域和医院目标
- 该地区75%或以上的STEMI接收中心参与了该项目，注册了Mission: Lifeline数据平台, 提交STEMI数据并参与使命:生命线区域报告
- 在以下指标方面显示出区域业绩的积极改善趋势:
- EMS FMC to PCI within 90 minutes
- Arrival at STEMI Referring Hospital to PCI within 120 Minutes
- Overall key processes and clinical outcomes
Mission: Lifeline STEMI Accelerator Project Conclusions
- 使命:生命线STEMI系统加速器示范项目代表了组织区域性STEMI护理的最大国家努力. By focusing on first medical contact-to-device time, coordinated treatment protocols, and regional data collection and reporting, 在指南目标范围内接受治疗的患者比例增加.
Source: 2016年使命:生命线区域医疗系统示范项目(加速器I)(link opens in new window) - 12个地区的EMS和医院之间的护理组织与STEMI患者再灌注沙巴足球体育平台的显着减少相关, and in-hospital mortality. 这些发现支持对患者采取更密集的区域紧急护理方法.
Source:2018年STEMI护理区域化对EMS转运患者PCI治疗沙巴足球体育平台和结果的影响(任务:生命线加速器II项目)
Mission: Lifeline STEMI Accelerator I and II Publications
- 2018年STEMI护理区域化对EMS转运患者PCI治疗沙巴足球体育平台和结果的影响(任务:生命线加速器II项目)(link opens in new window)
- 2016年使命:生命线区域医疗系统示范项目(加速器I)(link opens in new window)
- Supplemental Material - Mission: Lifeline Accelerator I Project
- 2016年社论:实施STEMI护理系统的挑战(link opens in new window)
- 2011 The Need for Regional Integrated Care for STEMI(link opens in new window)
附加任务:生命线STEMI加速器I和II资源
- 区域医疗系统示范项目:使命:生命线STEMI系统加速手册(link opens in new window)
- 任务:生命线STEMI加速器I示范项目(link opens in new window)
要了解如何参与区域化使命:生命线STEMI护理系统，请完成 Get More Information About Mission: Lifeline(link opens in new window) form. 美国心脏协会质量和系统改进小组成员将在48小时内与您联系.
