ATCEMS Performance Dashboard > Aspirin Administration to Patients Having a Heart Attack > Performance Measure Definition: Aspirin Administration for STEMI Alerts
Performance Measure Definition: Aspirin Administration for STEMI Alerts
Description: This is the percentage of patients assessed by EMS providers as meeting STEMI Alert criteria that appropriately receive aspirin (ASA).
Desired Outcome: All STEMI Alert patients receive aspirin before arrival at the hospital, when not contraindicated.
Relevance: Research has shown that early aspirin administration is beneficial in patients with STEMI. 
Measure Domain: Clinical care 
Type of Measure: Process
Operational Specifications 
Formula Description: Count of patients meeting STEMI Alert criteria who are documented as receiving aspirin as an intervention when indicated, divided by the count of all patients meeting STEMI Alert criteria. 
The resulting measure is expressed as a percentage. 
Unit of Analysis: Patient contact 
Population: 
  • Numerator: STEMI Alert patients who receive aspirin, or appropriately do not receive aspirin (e.g. allergy, history of gastrointestinal bleeding, etc.).  Patients who inappropriately receive ASA are not included in the numerator. 
  • Denominator: All STEMI Alert patients 
Measure Frequency: Quarterly 
Minimum Population/Sample: None 
Performance Standard: Administer aspirin to at least 95 percent of patients who meet STEMI Alert criteria and do not meet exclusion criteria each quarter.
Acceptable Quality Level: Performance may not fall below 87% for more than two consecutive quarters or any three quarters in a year. 
Interval Description: Not applicable 
Reporting Value: The percentage of patients meeting STEMI Alert criteria to whom aspirin is administered, as defined in the applicable version of the Austin-Travis County Emergency Medical System Clinical Operating Guidelines. 
Aggregation: Aggregate patients based on date/time of phone pickup in Communications Center for incident. 
Stratification: None 
Limitations: None 
Related Measures: 
  • CPI 04 - Aspirin Administration for ACS: This measure is generally similar to the STEMI Alert measure, but includes all suspected Acute Coronary Syndrome (ACS) patients.  The CPI measure excludes from calculations patients for whom aspirin administration is contraindicated.  The net result of these changes is that the patient contact counts for the CPI measure will be larger, and performance results will vary from the STEMI Alert results.
Notes: This indicator measures appropriate treatment of STEMI Alert patients.  Appropriate treatment includes administration of aspirin to STEMI Alert patients who have no contraindications to the treatment, AND withholding aspirin from those patients with contraindications.  Inappropriate treatment included failure to administer aspirin to patients with no contraindications, or administering aspirin to patients who meet contraindication criteria.
This indicator is one of several that are to be included in the STEMI Alert Bundle performance indicator (pending).  Measuring appropriate care, as opposed to strictly ASA administration, supports higher quality performance measurement.
Reporting 
ATCEMS Open Performance Dashboard 
City of Austin Open Data Portal 

References 
Office of the Medical Director, Austin/Travis County EMS System (2016).  “Clinical Operating Guideline C-01: Chest Pain, Suspected Acute Coronary Syndrome.” Austin-Travis County Emergency Medical Service System Clinical Operating Guidelines version 021716.
Office of the Medical Director, Austin/Travis County EMS System (2016).  “Clinical Standard CS-33: STEMI Alert Criteria.” Austin-Travis County Emergency Medical Service System Clinical Operating Guidelines version 021716.
Metadata 
Development Status: Actively Reporting 
Definition Version: Version A
Revision Date: 2017-01-27 
Revised By: David Andersen