TY - JOUR
T1 - Implementing a STEMI system of care in urban Bangalore
T2 - Rationale and Study Design for heart rescue India
AU - Ramesh, Aruna
AU - LaBresh, Kenneth A.
AU - Begeman, Rhea
AU - Bobrow, Bentley
AU - Campbell, Teri
AU - Chaudhury, Nayanjeet
AU - Edison, Marcia
AU - Erickson, Timothy B.
AU - Manning, John D.
AU - Prabhakar, Bellur S.
AU - Kotini-Shah, Pavitra
AU - Shetty, Naresh
AU - Williams, Pamela A.
AU - Vanden Hoek, Terry
N1 - Publisher Copyright:
© 2018
PY - 2018/6
Y1 - 2018/6
N2 - Background: A system of care designed to measure and improve process measures such as symptom recognition, emergency response, and hospital care has the potential to reduce mortality and improve quality of life for patients with ST-elevation myocardial infarction (STEMI). Objective: To document the methodology and rationale for the implementation and impact measurement of the Heart Rescue India project on STEMI morbidity and mortality in Bangalore, India. Study Design: A hub and spoke STEMI system of care comprised of two interventional, hub hospitals and five spoke hospitals will build and deploy a dedicated emergency response and transport system covering a 10 Km. radius area of Bangalore, India. High risk patients will receive a dedicated emergency response number to call for symptoms of heart attack. A dedicated operations center will use geo-tracking strategies to optimize response times including first responder motor scooter transport, equipped with ECG machines to transmit ECG's for immediate interpretation and optimal triage. At the same time, a dedicated ambulance will be deployed for transport of appropriate STEMI patients to a hub hospital while non-STEMI patients will be transported to spoke hospitals. To enhance patient recognition and initiation of therapy, school children will be trained in basic CPR and signs and symptom of chest pain. Hub hospitals will refine their emergency department and cardiac catheterization laboratory protocols using continuous quality improvement techniques to minimize treatment delays. Prior to hospital discharge, secondary prevention measures will be initiated to enhance long-term patient outcomes.
AB - Background: A system of care designed to measure and improve process measures such as symptom recognition, emergency response, and hospital care has the potential to reduce mortality and improve quality of life for patients with ST-elevation myocardial infarction (STEMI). Objective: To document the methodology and rationale for the implementation and impact measurement of the Heart Rescue India project on STEMI morbidity and mortality in Bangalore, India. Study Design: A hub and spoke STEMI system of care comprised of two interventional, hub hospitals and five spoke hospitals will build and deploy a dedicated emergency response and transport system covering a 10 Km. radius area of Bangalore, India. High risk patients will receive a dedicated emergency response number to call for symptoms of heart attack. A dedicated operations center will use geo-tracking strategies to optimize response times including first responder motor scooter transport, equipped with ECG machines to transmit ECG's for immediate interpretation and optimal triage. At the same time, a dedicated ambulance will be deployed for transport of appropriate STEMI patients to a hub hospital while non-STEMI patients will be transported to spoke hospitals. To enhance patient recognition and initiation of therapy, school children will be trained in basic CPR and signs and symptom of chest pain. Hub hospitals will refine their emergency department and cardiac catheterization laboratory protocols using continuous quality improvement techniques to minimize treatment delays. Prior to hospital discharge, secondary prevention measures will be initiated to enhance long-term patient outcomes.
KW - Angioplasty
KW - Quality improvement
KW - STEMI
KW - Thrombolysis
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U2 - 10.1016/j.conctc.2018.04.002
DO - 10.1016/j.conctc.2018.04.002
M3 - Article
AN - SCOPUS:85045043531
SN - 2451-8654
VL - 10
SP - 105
EP - 110
JO - Contemporary Clinical Trials Communications
JF - Contemporary Clinical Trials Communications
ER -