The NHAAP concentrated its initial efforts on addressing delays associated with healthcare provider recognition and treatment, notably in the emergency department setting. The program convened a working group, co-chaired by a cardiologist and an emergency medicine physician, to examine emergency department processes related to the care of these patients and identify delays to timely treatment. The working group concluded that patients presenting with symptoms consistent with acute MI, with ST-segment elevation on the initial electrocardiogram (ECG) and who had no contraindications to reperfusion therapy could effectively and safely be identified and treated within 30 min after emergency department arrival (12). The working group also recommended that in order to examine, process, and track improvement through a continuous quality improvement effort, the time from emergency department arrival to initiation of reperfusion therapy would have to be recorded for each patient, since the
purpose of tracking reductions in delay over time related to changes in the process of identification and treatment.
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