SUSTAIN

Project By-line:  Improving Systems of Follow-Up Care for Patients with STEMI

Introduction Paragraph: STEMI guidelines include post-discharge systems of care as IA-IB recommendations, yet little is known about the optimal approach to link current discharge practices to post-discharge systems of care in STEMI patients in the U.S. As preliminary work in the STEMI Accelerator 2 program, we conducted a survey of post-discharge practices for STEMI care among 58 hospitals across 12 regions in the U.S. The survey assessed hospital adoption of guideline recommendations for post-discharge care and identified gaps in care coordination, systems for care transition, and quality metrics associated with post-discharge care. These findings were used to develop the SUSTAIN intervention, a pragmatic, multicenter, prospective study designed to evaluate the impact of standardized deployment of local and regional systems for post-discharge care for STEMI patients at one year.

 Primary Aim: To improve P2Y12 inhibitor adherence for patients with STEMI for up to 12 months, and to improve adoption of guidelines for evidence-based processes in care transition.

 Design: SUSTAIN is a prospective observational improvement science study of 18 hospitals in the U.S.

 Metrics:

Primary endpoint: P2Y12 inhibitor use at 12 months

 Secondary endpoint: Adoption rate of guideline-based processes of care transition

 Timeline: September 2016 – October 1, 2018

Project Team Lead: Jeff Washam, PharmD (jeff.washam@duke.edu) and Francis Cosgrove, RN, ACNP (francis.cosgrove@duke.edu)

Forms and Templates: 

Action Plan for Add your Hospital Name

Clean Monthly Tracker

County map and Regional resources

D-3 Pillbox Video

Hospital Patient Referrals

Metrics example

Sustain Web Resources

Timeline 2017