STEMI Initiative Cuts Response Time by 72%

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A quality program at UNC Hospitals empowers non-physician clinicians to activate response teams for cardiology inpatients using triage protocols used by first responders.

UNC Hospitals physicians say initial results midway through an inpatient STEMI (ST elevation myocardial infarction) identification and treatment pilot project show response times have been cut by 72%.

George A. Stouffer, MD, chief of cardiology at UNC Hospitals, says the in-house initiative at the Chapel Hill-based health system began after clinicians noted a high mortality rate among non-cardiac inpatients suffering from STEMI.

“We initially did a study looking at our patients here at UNC. We did a subsequent study using a California database and found it was a problem in hospitals there and presumably nationwide,” says Stouffer, who published a research letter on his study this month in JAMA Cardiology.

“We put in place a quality improvement program at UNC to see if we could improve the times, and that was one of the reasons that patients were dying at a high rate—the delayed recognition and treatment,” Stouffer says.

Nationwide, Stouffer estimates that there are approximately 11,000 cases of STEMI each year among hospital inpatients, and about 4,300 deaths in this group. He says STEMI is difficult to detect, especially for inpatients, because they often don’t present with the “classic heart attack symptoms.”

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