Mich. Admin. Code R. 330.203 - Definitions; P to V

Rule 3.

(1) As used in these rules:

(a) "PCI" or "percutaneous coronary intervention" means a procedure used to open or widen a narrowed or blocked coronary artery to restore the blood flow that supplies the heart and is usually performed on an emergency basis for a STEMI patient.

(b) "Protocol" means a patient care standard, standing order, policy, or procedure for providing emergency medical services that is established by an MCA and approved by the department under section 20919 of the code, MCL 333.20919.

(c) "Provisional" means a one-time temporary time-limited status conferred on a facility by the department that most closely matches the current level of care based on the published criteria for accreditation or certification for which it is applying.

(d) "PSRO" or "professional standards review organization" means a committee established by a life support agency or an MCA for the purpose of improving the quality of medical care, as provided in section 1 of 1967 PA 270, MCL 331.531.

(e) "Quality improvement program" means actions taken by a life support agency, MCA, STEMI center or facility, or jointly between a life support agency, MCA, or STEMI center or facility with a goal of continuous improvement of medical care in accordance with the code. Actions must take place under a PSRO, as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(f) "Regional STEMI advisory council" means a committee established by a regional STEMI system whose function is to provide leadership and direction in matters related to STEMI system development in their region, and to monitor the performance of the STEMI agencies and healthcare facilities within the region, including, but not limited to, the review of STEMI deaths and preventable complications, and it is comprised of the following:

(i) MCA personnel.

(ii) EMS personnel.

(iii) Life support agency representatives.

(iv) Healthcare facility representatives.

(v) Physicians.

(vi) Nurses.

(vii) Consumers.

(g) "Regional STEMI plan" means a written plan prepared by a regional STEMI advisory council, and approved by the regional STEMI system, that is based on minimum criteria established by the department.

(h) "Regional STEMI system" means an organized group comprised of the local MCA within a region that integrates into the existing regional trauma network and is responsible for appointing a regional STEMI advisory council and creating a regional STEMI plan.

(i) "Regional systems of care authority" means an organization recognized by the department that is comprised of MCAs within a region and is also approved as the regional trauma network, which provides clinical oversight for the regional trauma system, regional stroke system, and regional STEMI system within the region.

(j) "RPSRO" or regional PSRO means a committee established by the regional STEMI system for the purpose of improving the quality of STEMI care within a recognized STEMI region as provided in sections 1 to 3 of 1967 PA 270, MCL 331.531 to 331.533.

(k) "Statewide STEMI care advisory subcommittee" means a STEMI care advisory subcommittee that acts as the department's subject matter experts regarding the clinical and operational components of STEMI care.

(l) "Statewide STEMI registry" means a system for collecting data that the department manages, analyzes, and disseminates.

(m) "Statewide STEMI system of care" means a comprehensive and integrated arrangement of emergency services personnel, STEMI centers or facilities, equipment, services, communications, MCAs, and organizations necessary to provide STEMI care to all patients within a particular geographic region.

(n) "STEMI" means an ST-segment elevation myocardial infarction defined by symptoms of myocardial infarction associated with an ST-segment elevation on an ECG.

(o) "STEMI bypass" means to forego EMS transport of a patient to the nearest healthcare facility for a healthcare facility whose resources are more appropriate to the STEMI patient pursuant to direction given to pre-hospital emergency medical services by online medical direction or predetermined triage criteria as established by department-approved protocols.

(p) "STEMI care" means diagnostic evaluation, triage, acute intervention, emergency transport, and other acute care services for STEMI patients who potentially require emergent cardiac care, and may include education, risk reduction, and subacute STEMI management.

(q) "STEMI diversion" means the re-routing of a STEMI patient from a STEMI care center that has one or more of its essential resources currently functioning at maximum capacity, or is otherwise unavailable, to an alternate STEMI care center to serve the best interests of the STEMI patient.

(r) "STEMI receiving center" means a healthcare facility designated by the department as having met the criteria set forth by a department-approved nationally recognized professional accrediting and certifying organization as having the resources to provide PCI, treatment, and referral for emergency STEMI patients 24 hours per day, 365 days per year.

(s) "STEMI referral facility" means a healthcare facility designated by the department as having met the criteria set forth by a department-approved nationally recognized professional accrediting/certifying organization as having the resources to provide treatment and referral services for STEMI patients 24 hours per day, 365 days per year.

(t) "STEMI response" means an individual who has been identified as a potential STEMI patient and requires the utilization of the STEMI system of care.

(u) "TJC" means the Joint Commission.

(v) "Triage" means classifying patients according to the severity of their medical conditions.

(w) "Verification" means an evaluation process conducted by a national professional accrediting and certifying organization, or the department, to verify resources and improve STEMI care.

(2) A term defined in the code has the same meaning when used in these rules.

Notes

Mich. Admin. Code R. 330.203

2023 MR 22, Eff. 11/9/2023