Usefulness of the CODE ST-Segment Elevation Myocardial Infarction Program to Improve Quality Assurance in Patients With ST-Segment Elevation Myocardial Infarction

Abstract

The highest mortality rate associated with acute coronary syndrome is observed in patients with ST-segment elevation myocardial infarction (STEMI). Quality care in STEMI management depends on timely reperfusion of the ischemic coronary artery. The CODE STEMI program has been developed to reduce delays and serves as a method to improve quality care in patients with STEMI. Our study aimed to investigate the effects of implementing the CODE STEMI program on quality care and hospital marketing strategy. Our research was a descriptive study with mixed evaluation methods. We enrolled 207 patients with STEMI who underwent primary percutaneous coronary intervention from 2015 to 2018. We used quantitative methods by tracking medical records and administrative documents, as well as qualitative methods by observation and in-depth interviews. Statistical analysis was done using Mann-Whitney and chi-square tests. Our study demonstrated reduced door-to-balloon time, total cost, and length of stay of patients with STEMI who were treated with the CODE STEMI program (p <0.001, p <0.001, and p = 0.009, respectively). In addition, there was a likely decrease in major adverse cardiac event incidence and mortality rate after the implementation of CODE STEMI. The hospital and patients expressed their satisfaction with the CODE STEMI program. The program proved to have good efficacy, effectiveness, optimality, acceptability, legitimation, and equity. It also met the marketing mix principles, which included increasing the total number of patients with cardiovascular diseases as well as increasing levels of public trust in STEMI management. In conclusion, the CODE STEMI program has a positive impact on quality care and hospital marketing strategy.