Virginia Heart Attack Coalition:Progress and Future Directions

Peter O’Brien, MD, FACCOctober 5, 2013

2008 Virginia Chapter ACC MeetingVirginia Heart Attack Coalition Mission Statement:

“To work collaboratively to improve systems of care for the early recognition and treatment of all Virginia residents

having heart attacks.”

VHAC/ML Strategic Plan

I. PHECG’s: Equipment, Training, Education and widespread use

II. Regional Organization/Activity: Sustaining STEMI councils and regional activity

III. ACTION: Regional/State data collection, ML recognition

I. Prehospital ECG’s

Joint OEMS/VHAC/AHA EMS survey 2009% of Vehicles with 12 leads

at the scene

OEMS Assessment Survey 2012% with Prehospital ECG’s

85%

15%

2

YesNo

The Other 15% Initiative

Partner with OEMS to achieve 100% PHECG in Virginia—New Survey Released this week!

85%

15%

2

YesNo

STEMI Showdown• Interactive, comprehensive STEMI teaching

session• Rapidly becoming a leader in STEMI lecturing

and EMS education• Allows assessment of audience skill level

during session

“STEMI Education—Why so Serious?”

Dr. Mike Kontos

Dr. Pete O’Brien

Dr. David R Burt

II. Sustaining Regional Organization and Activity

VHAC Regions

STEMI + Cardiac Resuscitation System CoverageAs of 04/28/2013

(665 STEMI Systems - 65.24% Population Coverage)(37 Cardiac Resuscitation Systems - 4.76% Population Coverage)

VHAC partners with AHA…

AHA VHAC

VHAC/ML Director John Dugan

STEMI Bill of Rights

III. Data and Performance: ACTION and Mission Lifeline

ACTION Site Distribution 2008—Virginia has 9

Last updated: 8/21/08

AK(1)

WA(11)

OR(9)

CA(20)

ID(1)

NV(1)

MT(2)

WY(0)

CO(7)

NM(1)

ND(1)

SD(1)

NE (4)

KS(8)

OK(4)

TX(26)

MN(5)

IA(6)

MO(12)

AR(1)

LA(2)

WI(11) MI

(12)

MI

UT(0)

AZ(2)

HI (0)

IL(23)

IN(14)

KY(2)

TN(10)

MS(3)

AL(1)

GA(10)

FL(17)

SC(4)

NC(23)

VA(9)

OH(22)

WV(1)

PA(23)

NY(11)

MD (10)

ME(2)

VT (0)

NH (1)

NJ (4)

MA (3)

CT (3)

DE (0)

RI (0)

DC (0)

Active Sites = 344

Current Site DistributionActive Sites =

Puerto Rico:Hawaii:Alaska :

755

1 7 3 International Participants: 2

CT : 5

DC : 4

DE : 4

MA : 5

MD : 26

NJ : 10

Virginia is Tied for 7th with the most sites!

Sounds like a plan, but show me the data…

% of Primary PCI<120 minutes 2004-05 (National Voluntary Hospital Reporting Initiative)

Nation Virginia0

102030405060708090

100

62 63

% of Primary PCI<120 minutes 2005-06 (CMS Hospital Compare)

Nation Virginia0

102030405060708090

100

67 70

% of Primary PCI<90 minutes 2010 (CMS Hospital Compare)

Nation Virginia0

10

20

30

40

50

60

70

80

90

100

90 94

% of Primary PCI<90 minutes 2011-12 (CMS Hospital Compare)

Nation Virginia0

10

20

30

40

50

60

70

80

90

100

95 95

D2B

D2B

It is more than D2B

D2B Median 78minutes100% D2B <90FMC 107

FMC2B

FMC2B

FMC2B (Median Times)

FMC2B

Virginia: FMC to Balloon

2010 2011 20120

20

40

60

80

100

120

9286 82

Series 3

Transfers

Mission Lifeline Hospital Awards Virginia

2011 2012 20130

2

4

6

8

10

12

14

16

18

3

9

16

Strategery!!

• Regional STEMI committees meet quarterly/biannually. Committees up to full representation by profession/organization/hospital/health care system with agenda, goals and meeting minutes

• All Centers on ACTION, participating in Regional Reports and 2/3rds are ML award

winners • At least one PCI center in each VHAC Region achieves Mission Lifeline STEMI Center

Accreditation

• All EMS have PHECG equipment, processes, education

• Leverage VHAC /ML for other statewide initiatives: VCSQI, Cardiac Arrest, Stroke?

THANK YOU Virginia ACC!!!