Outcomes | Indicators | Data source | Indicator definition |
---|---|---|---|
Service outcome | Number of admissions | Hospital-based assessments | The number of admissions for STEMI patients |
 | PCI rate | Hospital-based assessments | The proportion of STEMI patients who receive PCI |
 | Percentage of EMS transfer | Hospital-based assessments | The percentage of STEMI patients who are transferred by EMS agency |
 | Onset-to-FMC time | Hospital-based assessments | The time from onset to first medical contact of STEMI patients |
 | Door-to-balloon time | Hospital-based assessments | The time from arrival in hospital to PCI of STEMI patients |
 | FMC-to-device time | Hospital-based assessments | The time from first medical contact to PCI of STEMI patients |
 | Percentage of onset-to-FMC time ≤ 60 min | Hospital-based assessments | Percentage of STEMI patients with the time from onset to first medical contact ≤ 60 min |
 | Percentage of Call-to-EMS time ≤ 15 min | Hospital-based assessments | Percentage of STEMI patients with the time from calling EMS agency to ambulance arrival ≤ 15 min |
 | Percentage of Door-to-balloon time ≤ 60 min | Hospital-based assessments | Percentage of STEMI patients with the time from arrival in the hospital to PCI ≤ 60 min |
 | Percentage of FMC-to-device time ≤ 90 min | Hospital-based assessments | Percentage of STEMI patients with the time from first medical contact to PCI ≤90 min |
Patient outcome | In-hospital mortality | Hospital-based assessments | Proportion of STEMI patients discharged death |
 | 1-year mortality | Community-based household survey by telephone | Death rate of the STEMI patients within 1 year after hospitalization |
 | 1-year complication rate | Community-based household survey by telephone | Incidence rate of new vascular events of STEMI patients within 1 year after hospitalization |
Implementation outcome—reach | Number of patients visits | Community-based household survey | Proportion of the STEMI patients reporting care at a health facility |
 | Number of residents receiving health education | Community-based household survey | Number of individuals who receive education on STEMI awareness and COVID-19 knowledge |
 | Training the QI initiatives for Health providers | Questionnaire survey on healthcare providers | Number and proportion of the healthcare providers who receive the QI initiatives training |
Implementation outcome —adoption | Community engagement | Community-based household survey | Number of community residents attending the optimized QI initiatives |
 | Health providers engagement | Questionnaire survey on healthcare providers | Number of health providers attending the optimized QI initiatives |
 | Behavior change of healthcare providers | Questionnaire survey on healthcare providers | Change score of healthcare providers in compliance with protocol of clinical guidelines |
 | Health literacy change of residents | Community-based household survey | Change score of health literacy related to STEMI awareness and COVID-19 knowledge of individuals |
 | Attitude of health facility directors | Key informant interviews | Degree of acceptance of the optimized QI initiatives by directors from hospitals and EMS agency |
Implementation outcome—implementation | Fidelity | Key informant interviews | Degree that the optimized QI initiatives are implemented as planned in original protocol |
 | Feasibility | Key informant interviews | Extent that the optimized QI initiatives can be carried out in a specific setting |
 | Outer context | Key informant interviews | Macro-level external factors including social, funding, and leadership |
 | Inner context | Key informant interviews | Micro-level internal factors including NHC partnership, the programmatic staff, feedback, hospitals, EMS agency, community, household, and individual level |
Implementation outcome —maintenance | Sustainable of the effectiveness | Key informant interviews | Views on maintaining effectiveness from policy makers, health facility directors, healthcare providers, and residents |
 | Satisfactory of stakeholders | Key informant interviews | Satisfactory on effectiveness and implementation strategy of the optimized QI initiatives of policy makers, health facility directors, healthcare providers, and residents |
 | Financial sustainable | Key informant interviews | Views on funding and return on investment from policy makers and health facility directors |
 | Institutionalization of interventions | Key informant interviews | Core components which are transferrable and where local adaptation is needed for replication in other settings |