1. Mission: Lifeline 6.15.2015 -Task Force Meeting 1 ©2013, American Heart Association Julie Smith, RN BSN MHA Director Mission: Lifeline Nebraska

2. Improving the System of Care for STEMI Patients Mission: Lifeline – A System of Care 2

3. Welcome and Introductions – Julie Smith Physician Leadership – Update (Chair Discussion) Data Round 3 and EMS Equipment update Map – Gary Public Awareness Education – Hospital Receiving Software – Hospitals Adjournment Agenda 9/10/2015 3

4. Chairs Dr. Matt Johnson, Dr. Doug Kosmicki and Dr. David Cornutt have agreed to serve another term as chairs for Mission: Lifeline Dr. Ed Mlinek will remain the Hospital Advisory Lead Dr. Steve Martin will remain the Interventional Cardiologist Steering Committee Lead The EMS advisory council membership will remain unchanged with 22 members and 5 AHA/Mission: Lifeline representatives Physician Update 9/10/2015 4

5. State Reports for 4 th quarter 2014 include data from 5 NE PCI hospitals Regional Reports for 4 th quarter 2014 data will include 4 boarding PCI hospitals in SD, CO, and IA and the 5 NE PCI hospitals. State Reports for 2015 will eventually include data from the 12 NE PCI hospitals. (Retrospective data entry to Jan 2015 is currently being done by some facilities) Regional Reports for 2015 should include data from 12 NE PCI hospitals and the 4 boarding PCI hospitals. Data 9/10/2015 5

6. Data 4 th Quarter 2014 9/10/2015 6

7. Arrival at first facility to Primary PCI ≤ 120 minutes Data 4 th Quarter 2014 9/10/2015 ©2013, American Heart Association 7

8. Timed reports in Minutes Data Continued 9/10/2015 ©2013, American Heart Association 8

9. ED Arrival to First In Hospital ECG Data First ECG 9/10/2015 ©2013, American Heart Association 9

10. Arrival Mode Arrival Mode” 9/10/2015 ©2013, American Heart Association 10

11. DATA - Median Length of Stay and Transfer Out 9/10/2015 ©2013, American Heart Association 11 TIMES:State National Median length of stay at referral facility (min)6159 Median time from transfer out of Ref. facility to Arrival at PCI (mins)4133

12. Data – Median Time of Arrival to Primary PCI 9/10/2015 ©2013, American Heart Association 12 State 4th Qrt 2014 National 4th Qrt 2014 Median Time from Arrival to Primary PCI (Minutes) Arrived by EMS5649 Arrived by POV66

13. Improving the System of Care for STEMI Patients Equipment Round 3 Round 1 equipment is completed and 12 Lead Education is being conducted Round 2 applications were scored and EMS services were notified and some have received equipment and education is being scheduled Round 3 application is now open until June 30 th. 13

14. Improving the System of Care for STEMI Patients List EMS Agencies – Round 1 Equipment 27 awards *Bayard Fire and Rescue *Gering Volunteer Fire Department *Hartington Ambulance Squad *Kimball County Ambulance Service *Minden Fire Department *Mitchell Volunteer Fire Department *Santee Sioux Nation EMS 14

15. Improving the System of Care for STEMI Patients List EMS Agencies – Round 1 Equipment *Valley County Ambulance *Broken Bow Fire and Rescue *Crofton Rescue Squad *Humboldt Rescue *Cambridge Rescue Service *Henderson Ambulance *Superior Volunteer Rescue Squad *Burwell Rural Fire District 15

16. Improving the System of Care for STEMI Patients List EMS Agencies – Round 1 Equipment *Ponca Volunteer Fire & Rescue *Winnebago Tribal Rescue and Ambulance Service *Holdrege Fire Department/Rescue Squad *City of Geneva Rescue *Dakota City Fire Dept *Fullerton Rescue Squad *Phelps Memorial Health Center Emergency Services Dept *Sutton Volunteer Rescue Service 16

17. Improving the System of Care for STEMI Patients List EMS Agencies – Round 1 Equipment *Pender Volunteer Fire and Rescue *Pierce Rescue *Central City Ambulance *Hamilton County Ambulance 17

18. Improving the System of Care for STEMI Patients List EMS Agencies – Round 2 Equipment 38 total Antelope Memorial Hospital Ambulance Service St Paul Rescue Squad *City of Madison Fire & Rescue *Bertrand Rescue Unit *Rushville Volunteer Fire/Rescue *Garden County Health Services (Regional West Garden County) *Ord Volunteer Fire Department *Falls City Volunteer Ambulance Squad *Overton Vol Fire & Rescue 18

19. Improving the System of Care for STEMI Patients List EMS Agencies – Round 2 Equipment *Sumner-Eddyville-Miller Rescue *Hay Springs Vol Fire Dept *Chadron Volunteer Fire Dept *City of Grand Island Fire Department *Regional West Garden County dba Emergency Response Care *CHI Health Good Samaritan *North Platte Fire Dept *South Sioux City Fire Rescue *Nebraska City Fire Rescue *Crete Volunteer Fire and Rescue 19

20. Improving the System of Care for STEMI Patients List EMS Agencies – Round 2 Equipment *Brown County Ambulance Association *Village of Sutherland Rescue *City of Ravenna EMS *Valley Ambulance Services Inc *Imperial Emergency Medical Service Hemingford Volunteer *Randolph Rescue Unit Atkinson Fire and Rescue *Wood River Fire Dept Cherry Co. Ambulance Hebron Volunteer Fire 20

21. Improving the System of Care for STEMI Patients List EMS Agencies – Round 2 Equipment *Pawnee County Ambulance *Bloomfield Ambulance *Alliance Fire Department *Thayer County Health Services Syracuse Rescue Service *David City Vol Fire Dept/Rescue *Big Springs Rural Fire Protection District *Perkins County Ambulance 21

22. Improving the System of Care for STEMI Patients DHHS EMS Equipment allocations 2014 18 Total Maxwell – North Platte, Great Plains Health PCI Valparaiso – Lincoln PCI Malcom – Lincoln PCI Axtell – Kearney PCI Hospital Thedford – North Platte, Great Plains Health PCI Frontier Curtis Maywood – North Platte, Great Plains Health PCI Sutherland – North Platte, Great Plains Health PCI Elm Creek – Kearney PCI Wymore – Beatrice Community Hospital or Lincoln PCI Crete – Crete Area Medical or Lincoln PCI 22

23. Improving the System of Care for STEMI Patients DHHS EMS Equipment allocations 2014 Bennet – Lincoln PCI Hospital Loup City – Kearney or Grand Island PCI Hospital Greenwood – Lincoln PCI Hospital Southwest Rural – (Lancaster County) – Lincoln PCI Hospital Hallam – Lincoln PCI Hospital Waverly – Lincoln PCI Hospital Milford – Lincoln – Midwest Medical Ceresco – Lincoln PCI Hospital 23

24. Improving the System of Care for STEMI Patients MAP with EMS equipment awards (DHHS and M:L) 24

25. Improving the System of Care for STEMI Patients 9/10/20159/10/20159/10/2015 25 Public Awareness South Dakota

26. Improving the System of Care for STEMI Patients Nebraska Look – Don’t Drive Yourself – Call 911 26

27. Improving the System of Care for STEMI Patients 27

28. Improving the System of Care for STEMI Patients Call 9-11 Logo 28

29. Improving the System of Care for STEMI Patients Marketing – Concepts l 29

30. Improving the System of Care for STEMI Patients Hospital Staff and Physician Education 30

31. Improving the System of Care for STEMI Patients Regions – Education CAH/referring Hospitals 31

32. Improving the System of Care for STEMI Patients Hospital Education Jennie Melham – Broken Bow Phelps Memorial Hospital – Holdrege Memorial Health Care System - Seward Johnson County – Tecumseh Saunders County – Wahoo Kearney County – Minden Community Memorial Hospital –Syracuse Community Medical Center – Falls City Beatrice Community Hospital - Beatrice Brodstone Memorial – Superior Harlan County – Alma 32

33. Improving the System of Care for STEMI Patients Referring Hospital – Receiving 12 Lead ECG Equipment Jennie Melham – Broken Bow Phelps Memorial Hospital – Holdrege Memorial Health Care System - Seward Kearney County – Minden Nemaha County – Auburn Community Medical Center – Falls City Chadron Community Hospital – Chadron Brodstone Memorial – Superior Henderson Health Care Services – Henderson Providence Medical Center – Wayne Kimball Health Services – Kimball 33

34. Improving the System of Care for STEMI Patients PCI – Receiving 12 Lead Equipment Faith Regional Health Services – Norfolk (CarePoint) – Planned implementation – July Mary Lanning Healthcare – Hastings (Zoll) – In place Regional West Medical Center – Scottsbluff – Work In process Great Plains Health – North Platte (Physio) – Work In process Kearney Regional Medical Center – Kearney – Work in progress CHI - Good Samaritan Hospital – Kearney (Physio) – In Place and Planned updated CHI - St. Francis Medical Center – Grand Island (Physio) – Needs updated and working on transmissions 34

35. Questions? 9/10/2015 2012 AHA Mission: Lifeline 35 Questions?

36. 9/10/2015 2012 AHA Mission: Lifeline 36

37. Mission: Lifeline Nebraska Contacts 37 Gary W. Myers, MS, NREMT Sr. Mission: Lifeline Director EMS Consultant for Midwest Affiliate gary.myers@heart.org Brian Kranawitter Government Relations Director, Nebraska Midwest Affiliate brian.krannawitter@heart.org Beth Malina Director, Quality and System Improvement KC, Kansas and Nebraska Beth.malina@heart.org Ngia Mua Project Specialist – Mission: Lifeline NE, SD, ND, MN Midwest Affiliate ngia.mua@heart.org

38. Mission: Lifeline Nebraska