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Quality Definitions and Methodology

Timely Heart Attack Care

AMI-7a. Fibrinolytic Medication Within 30 Minutes Of Arrival

The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels and the heart can’t get enough oxygen. This can cause a heart attack. Fibrinolytic drugs are medicines that can help dissolve blood clots in blood vessels and improve blood flow to your heart. You should get them within 30 minutes of arrival at the hospital.

Higher percentages are better.

AMI-8a. PCI Within 90 Minutes Of Arrival

The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels, and the heart cannot get enough oxygen. This can cause a heart attack. Percutaneous Coronary Interventions (PCI) are procedures that are among the most effective ways to open blocked blood vessels and help prevent further heart muscle damage. A PCI is performed by a doctor to open the blockage and increase blood flow in blocked blood vessels. Improving blood flow to your heart as quickly as possible lessens the damage to your heart muscle. It also can increase your chances of surviving a heart attack. There are three procedures commonly described by the term PCI. These procedures all involve a catheter (a flexible tube) that is inserted, often through your leg, and guided through the blood vessels to the blockage. The three procedures are:

  • Angioplasty - a balloon is inflated to open the blood vessel.
  • Stenting - a small wire tube called a stent is placed in the blood to hold it open.
  • Atherectomy - a blade or laser cuts through and removes the blockage.

Higher percentages are better.

OP-1. Median Time to Fibrinolysis

Average (median) minutes after arrival before fibrinolytic medication received. (A lower number of minutes is better.)

OP-2. Fibrinolytic Therapy received within 30 minutes

The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels and the heart can’t get enough oxygen. This can cause a heart attack. Fibrinolytic drugs are medicines that can help dissolve blood clots in blood vessels and improve blood flow to your heart. You should get them within 30 minutes of arrival at the hospital.

Higher percentages are better.

OP-3. Average number of minutes before outpatients with chest pain or possible heart attack who needed specialized care were transferred to another hospital (a lower number of minutes is better)
OP-3b. Median Time to transfer patients for Acute Coronary Intervention

If a hospital does not have the facilities to provide specialized heart attack care, it transfers patients with possible heart attack to another hospital that can give them this care.

This measure shows how long it takes, on average, for hospitals to identify patients who need specialized heart attack care the hospital cannot provide and begin their transfer to another hospital.

It shows the average (median) number of minutes it takes from the time patients arrive in the Emergency Department until they are transported to a different hospital.

OP-4. Aspirin at Arrival

The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels, and the heart can’t get enough oxygen. This can cause a heart attack. Chewing an aspirin as soon as symptoms of a heart attack begin may help reduce the severity of the attack. This chart shows the percent of heart attack patients who were given (or took) aspirin within 24 hours of arrival at the hospital.

Higher percentages are better.

OP-5. Median Time to ECG

"ECG" (sometimes called EKG) stands for electrocardiogram. An ECG is a test that can help doctors know whether patients are having a heart attack.

Standards of care say that patients with chest pain or a possible heart attack should have an ECG upon arrival, preferably within 10 minutes.

This measure tells the average (median) number of minutes it takes before patients got an ECG.

Sometimes patients get an ECG done before they get to the hospital (for example, by the ambulance staff). This is counted as "0 minutes."