Chest Pain / STEMI Initiative

Medical Center AMI/Chest Pain Team Integration with EMS


The AMI/Chest Pain Team exists to facilitate a systems focus to chest pain/AMI/Acute Coronary Syndrome (ACS) patients across the continuum, to strengthen the relationship between the local EMS providers and the Medical Center and to improve the care of the ACS patient in our community and hospital.

Improve cardiac care for the ACS patient through evidence based practice, monitoring key quality outcome indicators, education, and efficient utilization of resources.

The primary focus of the committee is to ensure that Best Practice processes are evident throughout the facility and continuum of care through the following:
1. The Team will foster growth and communication among all disciplines as it pertains to the care of ACS/chest pain patient population. The committee will meet weekly to assess current state of care for ACS patient and develop process improvement needs. Once Chest Pain Center Accreditation process is completed, the Team will meet monthly to review case studies (STEMI/NSTEMI/UA) and continue to evaluate process improvement needs.
2. Evaluate outcome data to assess the quality of patient care, healthcare and nursing practices.
3. Assure a mechanism to disseminate knowledge of outcomes to staff.
4. Acquire knowledge of practice advancements to enhance quality of patient care
5. Consult with nursing personnel and healthcare professionals to improve practice.
6. Develop goals as related to improvement of practice.
7. Ensure on-going process improvement.
8. Evaluate recommendation from patient care areas/units.

1. Assess current state of our process in the care of our ACS patients through process improvement:
a. Door to EKG for STEMI, NSTEMI, and ACS patients
b. Door to Biomarker for NSTEMI patients
c. Door to Balloon for STEMI patients
2. Assure best practice guidelines are integrated into all protocols and medical practices.
a. The AMI/Chest Pain Team will facilitate culture of best practice and evidence based-medicine related to care of ACS patient throughout the organization through metric analysis, process change, and implementation of best practice related to recognition, evaluation, and treatment such as but not limited to, serial biomarkers, serial EKG's and Stress testing for low risk ACS patients.
b. Provide educational opportunities for staff providers regarding ACC guidelines, changes in protocols, importance of door to reperfusion, and EKG recognition for EMS, ED and hospital wide nursing.
3. Integrate Cardiology, ED and EMS for process improvement opportunities, sharing of metrics and monthly case reviews.
4. Integrate protocols between the Medical Center and EMS to improve outcomes for the ACS patient. The 2012-2013 focus will primarily be on Dothan area
EMS services.

• Medical Director of Emergency Services – Dr. Jones
• Chest Pain Center Physician Champion – Dr. Chennareddy
• ED Physician Chest Pain Champion – Dr. Fairclough
• Chest Pain Center Coordinator – Cathy Flinn MSN, RN, CEN
• AMI/Chest Pain Team Leader – Ben Ryals BSN
• Administrative Director Heart and Vascular Services – Mike Williams
• Vice President Patient Care Services – Diane Buntyn MSN, RN, OCN
• Director of Emergency Services – Angie Sims RN
• Pre-Hospital Services – Bruce McNeal
• Director Community Relations – Mark Stewart – ad hoc
• Cardiology – Art Smith
• EMS – Sean Gibson
• EMS – Dennis Poole
• EMS – Jason Trammell
• Rapid Response Team – Tracey Werstler BSN
• Patient Care Services – Karla Toben MSN, RN
• Patient Care Services – Brooke Segrest MSN, RN
• Lab – Sheryl Whiting
• Pharmacy – ad hoc
• Training and Development – ad hoc
• ED Quality Nurse – Dedra Blair RN
• Clinical Coordinator CDU/Observation Unit – Treela Howell RN

The AMI/Chest Pain Team has authority to:
• Recommend changes to practice
• Recommend changes to order sets
• Recommend changes related to patient flow
• Recommend policy changes related to the care of the cardiac patient
• Implement Educational Programs

• Chest Pain Center Tactical Work Group
• ED Leadership meeting
• ED Staff meetings
• Rapid Response Team as needed
• Quality Council as needed
• Cardiology Division meeting as needed
• Interdisciplinary Policy Committee as needed
• Pharmacy and Therapeutics Committee as needed
• Nursing Leadership as needed
• ED Medical Staff Meeting as needed

Signatures of Members:
Dr. Jones
Dr. Chennareddy
Dr. Fairclough
Cathy Flinn MSN RN CEN
Ben Ryals BSN
Mike Williams
Diane Buntyn MSN RN OCN
Angie Sims RN
Bruce McNeal
Mark Stewart
Art Smith
Sean Gibson
Dennis Poole
Jason Trammell
Tracey Werstler
Karla Toben
Brooke Segrest
Sheryl Whiting
Dedra Blair RN
Treela Howell