• Centers for Medicare & Medicaid Services (CMS). Specifications manual for hospital outpatient department quality measures (v 2.1a). Baltimore (MD): Centers for Medicare & Medicaid Services (CMS); 2009. 245 p.

Does not apply to this measure

This measure is used to assess the time (in minutes) from emergency department (ED) arrival to administration of fibrinolytic therapy in ED patients with ST-segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to ED arrival and prior to transfer.

Time to fibrinolytic therapy is a strong predictor of outcome in patients with an acute myocardial infarction (AMI). Nearly 2 lives per 1,000 patients are lost per hour of delay. National guidelines recommend that fibrinolytic therapy be given within 30 minutes of hospital arrival in patients with ST-segment elevation myocardial infarction. Despite these recommendations, few eligible older patients hospitalized with AMI receive timely fibrinolytic therapy.

Acute myocardial infarction (AMI); ST-segment elevation; left bundle branch block (LBBB); fibrinolytic therapy

Patients 18 years and older with an emergency department (ED) encounter who were discharged/transferred to a short-term general hospital for inpatient care or to a Federal healthcare facility with a diagnosis of acute myocardial infarction (AMI) and ST-segment elevation or left bundle branch block (LBBB) on electrocardiogram (ECG) performed closest to ED arrival (see the related "Denominator Inclusions/Exclusions" field in the Complete Summary)

Continuous variable statement: Time (in minutes) from emergency department (ED) arrival to administration of fibrinolytic therapy in acute myocardial infarction (AMI) patients with ST-segment elevation or left bundle branch block (LBBB) on electrocardiogram (ECG) performed closest to ED arrival and prior to transfer

Administrative data
Medical record

OP-1: hospital outpatient acute myocardial infarction: median time to fibrinolysis.

Centers for Medicare & Medicaid Services

United States Department of Health and Human Services

Centers for Medicare & Medicaid (CMS) Contractor

None

National Quality Forum

Hospital Quality Alliance

Measure was not adapted from another source.

2008 Apr

2009 Jan

This is the current release of the measure.

• Centers for Medicare & Medicaid Services (CMS). Specifications manual for hospital outpatient department quality measures (v 2.1a). Baltimore (MD): Centers for Medicare & Medicaid Services (CMS); 2009. 245 p.

This NQMC summary was completed by ECRI Institute on February 20, 2009. The information was verified by the measure developer on May 8, 2009.

No copyright restrictions apply.

The Specifications Manual for Hospital Outpatient Department Quality Measures (Version 2.1a, January 2009) is periodically updated by the Centers for Medicare & Medicaid Services. Users of the Specifications Manual for Hospital Outpatient Department Quality Measures must update their software and associated documentation based on the published manual production timelines.