At this level of “regionalization,” emergency physicians have the ability, knowledge, and leadership skills to lead the way in refining local STEMI systems. These highly efficient and interlinked local systems can then provide an effective starting point for complementary (not competing) larger-scale efforts.

The AHA fully recognizes the importance of these local efforts, and it is developing the tools, communication strategies, and networks to facilitate local-level regionalization. This complements current AHA efforts to provide a framework for national, state, and regional efforts. “Thinking globally and acting locally” will allow EM to help shape these efforts at all levels.

At times, the specialty of EM has been noted to be particularly sensitive to other specialties or authorities dictating or “recommending” guidelines on how we should best practice within our specialty. The AHA is clearly offering an alternative, inviting and encouraging EM to become as involved as we want to be and showcase what we do best.

With that in mind, we encourage you to become involved in Mission: Lifeline and offer your expertise in helping improve STEMI care for our friends, neighbors, and families. Take this opportunity to become involved through your local AHA affiliate or state chapter of ACEP and visit the Mission: Lifeline Web site at www.americanheart.org/missionlifeline.

In summary, Mission: Lifeline is a “calls to arms” for the specialty of emergency medicine. Our prominent participation will afford our specialty (and us as individuals) the opportunity to become involved (at multiple levels) in developing reasonable, evidence-based systems of care for STEMI patients in each community and throughout the United States.

References

1. AHA Consensus Statement: Recommendation to Develop Strategies to Increase the Number of ST-Segment-Elevation Myocardial Infarction Patients With Timely Access to Primary Percutaneous Coronary Intervention. Circulation 2006;113:2152-63.
2. Italian economist Vilfredo Federico Damaso Pareto observed in 1906 that 80% of the land in Italy was owned by 20% of the population. Joseph M. Juran, a pioneer in the field of quality management, suggested the principle that 80% of effects stem from 20% of causes and named it after Pareto.

This article was written by members of the American Heart Association’s ECC-STEMI Task Force, a key element of Mission: Lifeline. Dr. Robert O’Connor, chair of emergency medicine at the University of Virginia, leads the task force. Dr. Robert Solomon, medical editor-in-chief of ACEP News, is ACEP’s formal representative on the task force, which also includes several other emergency physicians.