Reducing STEMI Treatment Delays: A Quality Improvement Project at a Rural Community Hospital

CommonSpirit Mercy Hospital, a rural mountain hospital, consistently experienced a first medical contact-to-device time of ≥90 minutes for patients with ST-segment elevation myocardial infarction (STEMI), which threatened patient safety and outcomes, quality benchmarks, and achievement of Chest Pain Center Accreditation.

In 2024, 60% of the FMC-to-device time for STEMI patients was ≥90 minutes (average: 111 minutes). In response, the quality improvement team analyzed data from the National Cardiac Data Registry's Chest Pain-MI Registry, identified gaps in prehospital STEMI activation processes, and built a multiagency collaboration.

A multidisciplinary team implemented targeted outreach, education, and simulation training across regional emergency medical services agencies and internal emergency department teams. The project introduced standardized field activation protocols and the Pulsara platform for real-time communication, along with case summary follow-up and targeted improvement strategies.

Rural hospital settings present unique challenges to achieving guideline-recommended STEMI care. Measurable STEMI care improvement can be achieved by approaching the process with authenticity, enthusiasm, and a focus on stakeholder relationships.