Given their role as the primary connection point within the STEMI continuum of care, emergency physicians should be familiar with the immediate and future importance of the American Heart Association’s Mission: Lifeline, a national, community-based initiative to improve the health care system’s readiness for and response to STEMI.

This bold initiative, launched in May 2007, seeks to improve the quality of care for STEMI patients nationwide, with a specific focus on increasing the number of patients with timely access to primary PCI and minimizing time to reperfusion for all STEMI patients.

To accomplish these goals, the AHA has gathered providers from the entire STEMI continuum of care, including physicians, nurses, EMS and ED personnel, cardiologists and cath lab staff, hospital administrators, quality improvement specialists, payers, policy-makers, and others. The goal: integrated teams across the country working together at multiple levels within each community to improve STEMI systems of care.

Mission: Lifeline is an all-encompassing effort to improve each facet of STEMI care, realistically recognizing existing barriers. Mission: Lifeline is working to optimize STEMI recognition and response, both prehospital and inhospital; remove barriers to patient entry into the system; facilitate guideline-based reperfusion strategies at each site; develop regional systems of care involving EMS, STEMI referral hospitals (non-PCI centers), and STEMI receiving hospitals (PCI centers); and develop mechanisms for measurement of outcomes, utilizing efficient and accurate data collection.

Apart from improving the actual day-to-day processes of STEMI care, Mission: Lifeline also seeks to address closely related issues such as patient (and family) education, development of financial reimbursement models for EMS and hospitals, acquisition of sustainable funding sources, implementation of legislation related to improvement of STEMI care, and the distribution of applicable and useful knowledge.

In recognition of the enormous collaborative efforts such an endeavor will require, the AHA has wisely reached out to hundreds of individuals, organizations, and institutions in an effort to improve the entire nation’s quality of acute cardiovascular emergency care. In particular, Mission: Lifeline is reaching out to emergency medicine. Emergency medicine and EMS are particularly poised to be major leaders (and beneficiaries) of these massive efforts.

For example, the attention and assistance that EMS systems are receiving in this effort are substantial. Pre-hospital ECG has been recognized as a key to moving recognition of STEMI ever earlier into the infarct process. It is also critically important to encourage our patients and the public to call EMS (and to call earlier).