Meeting Notes
VHAC – Mission: Lifeline Monthly Conference Call
(May 12, 2011)
Welcome and Roll call by Dr. Pete O'Brien
AHA / VA Mission: Lifeline update by John Dugan
- John introduced himself to all of the participants as the new Virginia Heart Attack Coalition/Mission: Lifeline Director for Virginia
- Updated the group on the information that he had gathered across Virginia in his first few weeks of employment. He will continue to assess needs, opportunities and the status of STEMI systems in Virginia over the coming months.
- Notified everyone that there are 3 hospitals in Va that have qualified for M:L awards
Funding Update – John Dugan
- John reported that there are a couple of grants that have been applied for in central VA and that there is a fundraising dinner scheduled for next week in NoVa
VHAC Regional Updates
Southern – Dr. O'Brien reported on their most recent Regional meetings at Lynchburg General Hospital in April. There was good representation from Cardiology, Emergency Medicine, Administration, Nursing and EMS. The focus of the meeting was data review, protocols, and streamlining transfer processes.
Central – Participants from the Central Region were not available for this call, but John was able to report that their STEMI committee was planning to meet June 2.
Western – no representation.
Northern – no representation. Regional Leader Dr. John Sunew has moved to Texas, and the Steering Group is seeking his replacement, The Northern Virginia EMS Council has put forth a STEMI whitepaper that Melinda Duncan has distributed. This was seen to be a valuable tool and one that could be emulated by the rest of the State.
North Western – Dr. David Burt and Linwood Williams reported that they hope to have a conference call prior to the June 11 meeting. If not they plan to have a large contingent present so that they can have a good discussion during the state meeting.
Eastern – Joe Butz reported that the TEMS area is in the process of finalizing their STEMI plan. They are going to closely follow the plan that has been written by PEMS. ?Need comment on Sherwood Moore and Chesapeake's work.
Discussion items
- Dr. Burt updated the group on the partnership between the Society of Chest Pain Centers and AHA Mission: Lifeline. and their potential role in STEMI Center Accreditation. This information was released a week ago and more to follow at the June 11 VHAC/ML Summit.
- Determined that we want to have a discussion at the next conference call on EMS challenges across the state along with Door to ECG time issues.
- Dr. O'Brien discussed the importance of a broader representation of Stakeholders in each Region. Ideally, each Leadership Team should include EMS, ED, Cardiology, Administration, etc.
Upcoming Events – Dr. O'Brien
REMINDER – Statewide VHAC Mission: Lifeline Summit June 11, Chesterfield County Training Center. Please pass the word.
"60 is the new 90": Optimizing the EMS Interface in STEMI care
(November 2010)
Drs. David Burt and Pete O'Brien conducted the Virginia Heart Attack Coalition-Mission Lifeline's STEMI Provider Course at the 2010 EMS Symposium in November. Lori Hollowell, Senior Director MAA Mission: Lifeline, was also on hand to give an update on the AHA's Mission Lifeline and related efforts. Over 50 EMS personnel participated in this lively and interesting instructional. This event included clinical scenarios with an emphasis on ECG interpretation, correlation with cardiac catheterization films and interactive case discussion. The course was concluded with a breakout session addressing existing challenges to rapid recognition and reperfusion, allowing providers from across the Commonwealth to share experiences and best practices.
"Reperfusion Road Show" in Bath, VA
(October 2010)
"Make HASTE, Don't Delay" Heart Attack and Stroke Education & Training
STEMI/Stroke BootCamp and Congregational Health Assessments and "Make HASTE, Don't Delay" Presentations
The "2010 STEMI & Stroke BootCamp" educational workshop was held on October 19. We wish to thank workshop contributors and participants for making the event a success! Below are downloadable presentations from the event. Additional presentations will be added as they become available:
- Congregational Health Assessment Findings (.pdf), Rev. Andrea Lomboy
- Community Leaders Luncheon presentation (.ppt), David R. Burt, MD
- STEMI Stroke BootCamp (.ppt), David R. Burt, MD
- Time is Muscle (.ppt), Paul T. Frantz, MD
VHAC/Mission: Lifeline Task Force Meeting
(September 2010)
The attendees of the VHAC/Mission: Lifeline Task Force meeting were welcomed by Paul Sharpe followed by a short welcome by Dr. David Burt which included thanks and praise to Keltcie Delmar for her many contributions to the VHAC team. Regional updates from each of the regional leaders consisted of a brief overview with the Mission: Lifeline progress tool showing hospital and system activity in each region of Virginia. Presenters included John Sunew, Sheryl Crim, Joe Butz, and other VHAC Regional Leads. Although presented in different words, the commonality throughout the discussions centered on "patient care versus market share" or as the term the NASCAR announcer Darrel Waltrip has popularized, "co-opetition". Among the competitive states of the hospital systems, Mission: Lifeline and VHAC share the goal of patient-centered care, planned pathways or conduits, and achieving the best outcomes through relationships, data collection and sharing and reassessment of processes in place.
Following the regional updates, Webmaster Jon Rice updated the group on the VHAC website and possible ways to create and maintain interest. The "Overview of the VHAC website" can provide more website information. Dr. David Burt asked all attendees to complete a survey that will be used to solicit website content as updates are needed.
All the attendees were able to meet and network with each other during the wonderful vegetable lasagna lunch. After lunch, Lori Hollowell highlighted the Mission: Lifeline social community. As an update for those who attended, Sheryl Crim was the first to request Lori as a friend !
The meeting then moved onto Dr. David Burt asking Lori to give a brief overview of what is a Mission: Lifeline Director? Becki Mann, AHA VP of Major Gifts and Foundations, presented an overview of the goals for funding Mission: Lifeline in Virginia and provided a state-wide list of foundations. The most exciting announcement came as Dr. Pete O'Brien, amidst the company of Dr. Michael Kontos, Dr. David Burt, Paul Sharpe, Chuck Bartlett, AHA Senior VP of Health Strategies, Becki Mann and Lori Hollowell, revealed that with the combined efforts of the ACC, ACEP and several private donors, funds have been secured to hire a Mission: Lifeline Director for Virginia. This is great news as Virginia cultivates its STEMI systems of care on a local, regional and state level. The project team breakouts allowed for each group to discuss goals and strategies to improve each.
The meeting wrapped up with plans to hold the Spring 2011 Task Force meeting in conjunction with an educational forum... more information to be announced soon so stay tuned !!
STEMI BootCamp Webinar Playback Available
(August 2010)
Playback is now available for the Mission: Lifeline STEMI BootCamp Webinar from Monday, August 23. This session focused on the "5 Essential Elements of Reperfusion" and their importance in optimizing local STEMI Systems of Care. Dr. David Burt gave a presentation and was then joined by Dr. Michael Kontos and Dr. Peter O'Brien for a "STEMI Fireside Chat" Q & A session with Webinar participants. You can access playback of the Webinar on the Mission:Lifeline Community Social site. To download the STEMI BootCamp Webinar slide set, click here (.ppt) -- feel free to share with others who might be interested!
The Virginia Heart Attack Coalition-Mission: Lifeline
Continues to Gain Momentum
(March 2010)
The Virginia Heart Attack Coalition-Mission: Lifeline (VHAC-ML) concluded another successful Task Force Meeting, as evident by the presence and active involvement of over 40 attendees at our gathering in Richmond on March 25, 2010. During this busy and productive event, members and guests heard presentations from each Project Team, Regional Leads, the Virginia Office of Emergency Medical Services (OEMS), and representatives from the American College of Cardiology (ACC) and the American Heart Association's (AHA) ACTION-GWTG ("Get With the Guidelines") Registry. The organizational and political challenges of streamlining STEMI care were openly discussed as Virginia moves forward to meet the Mission: Lifeline’s goals.
Paul Sharpe RN, NREMT-P from the OEMS, reported on adoption of an EMS & STEMI white paper by the Medical Direction Committee, and gave an update on implementation of the National Emergency Medical Services Information System (NEMSIS), the data collection tool that will be used by all EMS agencies, to allow standardized data collection across the state, including data related to STEMI patients. There was also discussion about an EMS Inventory of 12-lead ECG equipment and training currently underway by OEMS, to help assess support needed in the field. The Office hopes to use the results to help establish a special grant cycle that focuses on increasing the number of agencies providing optimal STEMI care.
Recognition of Mission: Lifeline STEMI Centers was presented by Eric Walker of AHA and Kim Hustler of the ACC. Dr. Chris Granger from Duke University gave a presentation on the RACE program in North Carolina and talked about how they dealt with a variety of challenges and barriers. A discussion entitled “ACTION-Revelations From the Trenches” was conducted by a panel of users to assist those in transitioning to this registry.
The Regional Leads of all six VHAC regions discussed activities in their areas, key individuals and organizations on their teams, and progress in setting up ideal STEMI systems. In addition, the Regional Organization and Development team discussed ways to enlist the involvement of key stakeholders across the state in an effort to drive effective change. Going forward, the Regional Leads are charged with completing a STEMI System Progress Tool, as recommended by the AHA’s Mission: Lifeline. This important document serves as a “checklist” of the ideal components of a STEMI System -- everything from ECG education for EMS providers to single call activation of the Cardiac Cath lab.
The Data and Evaluation Project team forwarded a proposal as to how data about reperfusion times would be collected and presented. The Website and Tool Shed team discussed the VHAC website and plans for developing an online repository of protocols and other tools to assist members in improving STEMI care. Plans for a D2B Webinar are also underway.
The next VHAC-ML task force meeting will be held in Richmond in September. All those interested in improving STEMI care in the Commonwealth are encouraged to attend.
The Virginia Heart Attack Coalition-Mission Lifeline (VHAC-ML) Closely Focused on Education and Protocol Guidance
(December 2009)
- An EMS position paper on STEMI systems prepared by members of the VHAC-ML Task Force, including representation from EMS field providers, was presented and approved by the Virginia Office of EMS (OEMS) Medical Direction Committee. The document, which is carefully constructed to address concerns on a state and local level, uses ML Criteria to outline recommended strategies and tactics, and provide guidance for EMS agencies and providers in fine-tuning STEMI protocols.
- Mission Lifeline’s STEMI Provider Course was taught at the annual EMS Symposium in November by Drs Pete O’Brien and David Burt. Over 100 EMS personnel participated in this intensive class that included real life case scenarios. AHA STEMI Provider Manuals were given to all participants for further study and review. A vendor display booth at the Symposium further promoted Mission Lifeline and the importance of building STEMI systems of care, to the 3500+ attendees.
- Virginia OEMS provides monthly satellite training for EMS providers across the state, and worked with AHA and ML-VHAC to produce a segment for November outlining pre-hospital response to STEMI in the field. Dr Mike Kontos served as the Course Instructor, assuring the training adhered closely to ML Criteria. The course will remain accessible via web for the next year.
Virginia Heart Attack Coalition/Mission Lifeline Making Great Strides to Improve MI Care in the Commonwealth
(September 2009)
The VHAC/ML Task Force held its fourth meeting in Richmond on September 22, 2009. This was the first statewide meeting after a highly successful May Summit to gather all Coalition members and stakeholders. Progress continues as this important initiative continues to gather momentum.
Over 25 participants, from across Virginia and the STEMI Stakeholder spectrum, attended this Richmond event. Participants discussed a STEMI position paper to be presented to the State EMS, and heard updates on data from the Virginia Department of Health, the status of AHA funding, and reports from Project Teams and Regional Leaders.
The work of VHAC/ML is currently being carried out by three Project Teams. These subcommittees outlined their progress to date. The Regional Organization and Development Team has identified six separate Regions and established Regional leadership structures. Each Regional Lead discussed their current status, including challenges and opportunities.
The Data and Evaluation Team presented data demonstrating reductions in door to balloon time when 1995/96 was compared to 1998, an effect that was seen in each of the 6 regions. Summary data of over 1100 patients included demonstrated 85% of Virginia STEMI patients treated in < 90 minutes. Data from a survey of Virginia PCI and non-PCI hospitals was presented. Subsequently, this information will be helpful to better target educational and equipment needs for EMS to improve pre hospital recognition.
Finally, the Field Adaptations-Toolshed/Web team presented the website, www.virginiaheartattackcoalition.org, and discussed improvements and updates to follow. Work begins on a Toolkit which will provide participants with important resources for education and process improvement. This will include order sets and pathways to assist individualizing STEMI care for each hospital. In addition, the goal is to separate out educational material based on provider (e.g., EMS, ED, cardiologist, nurse, etc), for ease of use.
The “Virginia Heart Attack Coalition” (VHAC) is a volunteer collaborative that is helping to initiate the AHA’s Mission: Lifeline guidelines in Virginia and fostering cooperation and coordination of STEMI care providers.