The Michigan Department of Health and Human Services (MDHHS) approved a new rule on November 9, 2023, to establish a statewide system of care for ST-elevated myocardial infarction (STEMI) patients. The STEMI system will utilize the existing regions and Medical Control Authorities (MCAs) established for the trauma system of care in the state.
The rule requires all facilities to be designated as either a STEMI receiving center (those capable of performing primary PCI or other interventions for these patients) or a STEMI referring center (those focused on identifying, triaging, stabilizing, and transporting STEMI patients). In order to be designated by MDHHS, a hospital must be accredited by an approved organization.
Corazon has worked with MDHHS for over eight years as a named accrediting body related to Certificate of Need (CON) standards for hospitals and freestanding outpatient facilities (FSOF) offering interventional cardiology (PCI) services with open heart surgery support offsite. As a result, Corazon has been named in the STEMI system of care rule as a recognized accrediting body.
Corazon offers two accreditations for hospitals in Michigan to be designated by MDHHS. Those achieving Corazon PCI Accreditation can be designated as a STEMI receiving center, and those achieving Corazon Chest Pain Center (CPC) Accreditation can be designated as a STEMI referring center.
Some of the core components of Corazon accreditation are:
- Metrics related to the timely treatment of STEMI patients;
- Program outcomes data, monitored quarterly through registry reports or equivalent program dashboards;
- STEMI patient identification, triage, and treatment protocols;
- Collaboration and communication with emergency medical services (EMS) providers;
- Community outreach and education efforts (which may also include EMS providers); and,
- Appropriate physician and staff credentialing, training, and ongoing education.
MDHHS is currently establishing committees under the new rule to review best practices and data requirements for STEMI centers across the state. Corazon recommends that providers reach out to see how their physicians can apply or be considered for membership in these committees. It is important to note that the rule does intend for any outcomes of these committees to be recommendations that will be incorporated into the accreditation and designation process. It is not their intent to overwrite existing protocols or processes that are in place but ensure they all adhere to a statewide standard.
Hospitals should also pursue accreditation if they have not already done so. As an accrediting body, it will be Corazon’s responsibility (rather than the hospital’s) to monitor recommendations from MDHHS, incorporate them into the accreditation standards, and then communicate those requirements to client hospitals, making it easier to remain up to date on what is being evaluated. Furthermore, Corazon’s existing PCI and CPC accreditations have been recognized “as-acceptable” by MDHHS, meaning that hospitals currently accredited by Corazon are already in good standing for designation. It also means that some of the unknowns still being defined, particularly related to the data requirements, have the opportunity to be influenced by how hospitals report this information to Corazon through the accreditation process.
With all hospitals needing to be accredited, those that are able to pursue accreditation sooner than later will be better positioned than those who wait and may have to concede schedule availability to other facilities that signed contracts earlier than they did.
Any regulatory change brings with it questions and different considerations to evaluate, but Corazon provides clarity to navigate the process and acts as a conduit to ensure compliance for all accredited facilities.
By Michael Church