1. Prepared March 2011
How-to Guide
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
2. Prepared March 2011
Contents
Introduction.............................................................................................. 3
SFL European Executive Board, Members & Partners.............................. 4
Building the Structure................................................................................ 6
Your Local Structure....................................................................... 6
SFL Country Champion................................................................... 6
SFL Steering Committee................................................................. 6
SFL Task Force................................................................................ 7
The SFL National Project Coordinator............................................ 7
Situation Analysis and Strategic Planning.................................................. 8
Getting Started................................................................................ 8
Mapping and Analysing Your Situation........................................... 8
Identifying Barriers to the Use of PCI............................................. 9
Defining Objectives and Developing a Strategic Plan..................... 9
Publishing Your Findings.................................................................. 9
Securing Budget.............................................................................. 9
Monitoring Systems and Measuring Success.................................. 10
Securing and Working with Industry Partners.................................. 10
Analysis and Planning Case Study.............................................................. 11
Template Materials
Stent for Life Initiative Action Check List........................................... 13
Stent for Life Initiative Country Situation........................................... 14
Stent for Life Initiative Barriers.......................................................... 15
Stent for Life Initiative Reporting Template........................................ 16
For further information contact:
Zuzana Kaifoszova
SFL Project Manager, Europe
Email: kaifosz@gmail.com
Phone: +420 724 547 303
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
3. Prepared March 2011
Introduction
Dear Colleagues,
Welcome to the Stent for Life Initiative Toolkit, which I trust you will find useful not only in helping to
set up your local Stent for Life Initiative, but also in driving the Initiative forward and achieving
positive change in your country.
As you know, the Stent for Life Initiative (SFL) is a unique European platform for interventional
cardiologists, government representatives, industry partners, advocacy groups and patients to work
together and, by shaping the healthcare systems and medical practices, ensure that the majority of
STEMI patients will have an equal access to the life saving indication of p-PCI. There are currently
ten countries signed up to SFL: Bulgaria, France, Greece, Serbia, Spain, Turkey (all since 2009),
Egypt, Italy, Romania (since 2010) and Portugal (2011).
SFL’s overall aim is to improve the delivery and patient access to the life-saving indications of PCI,
thereby reducing the mortality and morbidity of patients suffering from acute coronary syndromes.
There are two key objectives that will determine our success:
1. Define regions and countries with an unmet medical need in the optimal treatment of ACS
2. Implement an action programme to increase patient access to p-PCI where indicated:
• To increase the use of p-PCI to more than 70% among all STEMI patients
• To achieve PCI rates of more than 600 per one million inhabitants per year
• To offer 24/7 service for p-PCI procedures at invasive facilities to cover the country STEMI
population need
As part of SFL Initiative, your task is to meet these objectives in your country, and this Toolkit will
provide you with guidance to do this. Within these pages you will find advice on all aspects of SFL,
including setting up your local SFL structure and Task Force, establishing external partnerships,
mapping the local situation, developing a strategic plan and delivering changes in local practice.
We urge you to familiarise yourself not only with the current contents, but also any updates we send
as new materials become available.
Finally, we would like to thank you for your hard work and commitment to the success of this
important initiative. We value your feedback so please do not hesitate to contact us if you have any
questions or comments on the toolkit.
Yours faithfully,
Zuzana Kaifoszova Steen D. Kristensen
Stent for Life Initiative Project Manager, Europe Stent for Life Initiative Co-Chairman
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
4. Prepared March 2011
SFL European Executive Board, Members & Partners
Executive Board
Prof. Steen D. Kristensen, SFL Co-Chairman
Dr. Jean Fajadet, SFL Co-Chairman and EAPCI President Elect (2009-2011)
Dr. William Wijns, EAPCI past-president (2009-2011)
Prof. Carlo di Mario, EAPCI President (2009-2011)
Prof. Petr Widimsky, SFL past Chairman
Project Management
Dr. Zuzana Kaifoszova, SFL European Project Manager
Marielle de la Torre, EAPCI Executive Officer
Member Countries
Bulgaria, Egypt, France, Greece, Italy, Portugal, Romania, Serbia, Spain and Turkey.
Participating Organisations
EuroPCR is made up of the winning elements of open-mindedness,
innovation and a patient-centred approach, with discussion and debate
on the different treatment options in a constructive manner. In line with
this, the cardiovascular community identifies the best treatment option for
each individual patient. Safe, effective, patient-centred healthcare will
help us reduce the burden of cardiovascular disease. Life-saving PCI
should be the basis of our daily practice and EuroPCR provides
information on the latest techniques, updates and breakthrough science,
allowing this information to be turned into actions that will improve the
quality of life of the patients. EuroPCR is one of the initiators of SFL,
along with the EAPCI.
The European Association of Percutaneous Cardiovascular Interventions
(EAPCI) is a Registered Branch of the European Society of Cardiology
(ESC). It was created in September 2006 as a result of a joint venture
between the ESC Working Group on Interventional Cardiology and
EuroPCR. EAPCI has over 3100 members and 8 committees. Via its
activities, it strives to become “the” exchange forum for all who care
about cardiovascular health and wish to contribute to its improvement
through the application of percutaneous cardiovascular interventions. The
EAPCI is one of the initiators of SFL, along with EuroPCR.
The ESC Working Group on Acute Cardiac Care aims to advance the
knowledge in major life-threatening fields of cardiology such as acute
coronary syndromes, cardiogenic shock, cardiac arrest, cardiac
arrhythmias and acute heart failure, by providing training and education
to physicians and nurses and by improving the outcome in patients
admitted to ICCU's.
National Cardiology Societies and/or National Working Groups for Interventional Cardiology
(WGIC)
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
5. Prepared March 2011
Industry Partners (European Level)
Stent for Life Initiative is supported by industry partners, but they have no influence on the scientific content.
Abbott Vascular offers a comprehensive device portfolio, including
products for carotid and coronary artery, peripheral vascular and structural
heart disease, and vessel closure.
Biotronik is a leading European company in the field of biomedical
technology. It focuses on devices for vascular intervention and
electrotherapy of the heart.
Boston Scientific is a worldwide developer, manufacturer and marketer of
medical devices whose products are used in a broad range of
interventional medical specialties.
Cordis Johnson&Johnson is a leading developer and manufacturer of
breakthrough stents, catheters and guidewires for interventional medicine,
minimally invasive computer-based imaging, and electrophysiology.
Eli Lilly, a leading innovation-driven corporation, is developing a growing
portfolio of first-in-class and best-in-class pharmaceutical products by
applying the latest research from its own worldwide laboratories and from
collaborations with eminent scientific organizations.
Medtronic is the global leader in medical technology. Medtronic develops
and manufactures a wide range of products and therapies providing a
continuum of care to diagnose, prevent and monitor chronic conditions.
Philips Healthcare is committed to developing tools throughout the
complete cycle of care – from disease prevention to screening and
diagnosis, to treatment, health management and monitoring – including
cardiology, oncology, critical care and women’s health.
Terumo Europe manufactures, imports, exports, markets and sells a wide
range of products for angiography, cardiology and cardiovascular
systems, transfusion, clinical test systems, patient monitoring and
diabetes care.
The Medicines Company is focused on advancing the treatment of critical
care patients through the delivery of innovative, cost-effective medicines
to the worldwide hospital marketplace.
Iroko Cardio international Sàrl is a privately held pharmaceutical company
located in Geneva, Switzerland and Philadelphia, USA. It manufactures
and markets Aggrastat® worldwide (with the exception of the USA) in
collaboration with regional distribution partners. Iroko Cardio aims to
contribute to the reduction of MACE.
Iberhospitex Cordynamics was founded in 1980 by Aniceto López, the
current chairman of the group, with the aim of developing innovative,
highly performing products. IHT designs, manufactures and markets a
wide range of single-use hospital supplies.
InspireMD Ltd. is a medical device company focusing on the development
and commercialisation of its proprietary stent platform technology – The
MGuard net protective stent. MGuard is designed for high risk coronary
patients; a market that consists of over two million patients per year
worldwide.
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
6. Prepared March 2011
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
7. Prepared March 2011
Building the Structure
Your Local Structure
Getting the right organisational structure for the Stent for Life Initiative in your country will provide
you with a solid foundation from which to achieve the Initiative’s objectives. It is worth taking the time
to make sure your structure is effective and the best possible people and organisations are involved
and represented.
The typical SFL structure looks like this:
SFL Country Champion
SFL Steering Committee
SFL Task Force
SFL National Project Coordinator
We recommend that you mirror this structure unless there are compelling reasons to adopt a
different one in your country.
SFL Country Champion
The SFL Country Champion is likely to be a well-known and respected cardiologist, and acts as the
figure-head and ambassador for the SFL Initiative. The Country Champion’s roles and
responsibilities include:
• Securing support and partnership from the local National Cardiac Society
• Leading the SFL Task Force and the development and execution of the Country
Implementation Plan
• Serving as primary contact for the SFL European Executive Board and SFL Project Manager,
Europe
• Collecting any available data on AMI treatment in the local country and monitoring how the
situation is changing
• Leading national level discussions with third parties, including government authorities,
healthcare payers, hospitals, etc to facilitate the logistics for improved access to p-PCI
SFL чемпионом страны, вероятно, будет хорошо известный и уважаемый кардиолог, и
он должен выступать в качестве главной фигуры и полпреда SFL инициативы в
стране. Роль чемпиона страны и обязанности включают в себя:
• Обеспечение поддержки и партнерства с Национальным обществом кардиологов;
• Руководство SFL Рабочей группой, разработка и реализация Государственного
(Регионального) Плана Внедрения SFL инициативы;
• Работа в качестве основного контактного лица для SFL Европейского
Исполнительного Комитета и SFL Европейского проект-менеджера;
• сбор любых данных о лечении ОИМ в стране и мониторингапроисходящих
изменений;
• Проведение дискуссий национального уровня с третьими лицами, в том числе
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
8. Prepared March 2011
государственных органов, сферы здравоохранения, больниц и т.д. для облегчения
логистики для улучшения доступа к р-PCI
SFL Steering Committee
The SFL Steering Committee is the scientific body that oversees the gathering of scientific evidence
in the country and provides broad strategic oversight for the SFL Initiative. It assists the Country
Champion in leading the SFL Task Force and developing the Country Implementation Plan. The
Steering Committee must be entirely made up of respected cardiologists, patient/advocacy group
representatives or other relevant experts, and should not contain any representatives of industry
partners. The SFL Steering Committee is also responsible for reporting on progress to the SFL
European Executive Board.
SFL Управляющий Комитет является научным органом, который осуществляет надзор
за сбором научных данных в стране и обеспечивает широкий стратегический надзор
за проведением SFL инициативы. Она помогает SFL чемпионам страны в руководстве
SFL Рабочей группой и в реализации Государственного (Регионального) Плана
Внедрения SFL инициативы. SFL Управляющий Комитет должен состоять из
уважаемых кардиологов, представителей групп (обществ) защищающих интересы
больных или других соответствующих специалистов, и не должны содержать
представителей партнеров от индустрии. SFL Управляющий Комитет несет
ответственность за прогресс инициативы и отчетность перед SFL Европейским
Исполнительным Комитетом.
SFL Task Force
The SFL Task Force is responsible for carrying out the Country Implementation Plan, and should be
drawn from representatives of all the key SFL stakeholders who are able to dedicate resources and
expertise. Under the leadership of the SFL Country Champion and Steering Committee, and
coordinated by the National Project Coordinator, the Task Force’s responsibilities include:
• Mapping and analysing the local situation
• Identifying barriers to effective use of PCI
• Securing additional local industry and patient group partners as necessary
• Approaching and working with local government as necessary
• Developing tactical detail of Country Implementation Plan
• Securing and developing budgets
SFL Рабочая группа отвечает за выполнение Государственного (Регионального)
Плана Внедрения SFL инициативы, и должны быть представлена членами всех
основных заинтересованных сторон SFL, которые способны отдавать ресурсы и опыт.
Под руководством SFL чемпиона страны и Управляющего комитета, и при помощи
координирующих действий National Project Coordinator/Manager, обязанности SFL
Рабочей группы включают в себя:
• Отображение и анализ местной ситуации
• выявление препятствий на пути эффективного использования PCI
• Обеспечение дополнительной группы партнеров со стороны индустрии и
представителей групп (обществ) защищающих интересы больных по мере
необходимости
• Работа с местными органами власти по мере необходимости
• Разработка тактических деталей Государственного (Регионального) Плана
Внедрения SFL
• Разработку бюджетов
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
9. Prepared March 2011
The SFL National Project Coordinator/Manager
Recruiting the right Project Coordinator is obviously very important to the success of the SFL in your
country. Although the Project Coordinator will not set your objectives or determine the strategy, he or
she will be responsible for ensuring that the strategy is carried out and the objectives are met. The
Project Coordinator role will include some or all of the following elements:
• Liaison with and reporting to the SFL Steering Committee
• Coordination of SFL partners, including the SFL Task Force and the resources at their
disposal
• Providing administrative support to the SFL Country Champion
• Recruitment of additional partners, and securing additional funding if required
• Liaison with third parties, including government and patient groups
• Liaison with the SFL Project Manager, Europe, and with other SFL National Project
Coordinators/Managers
• Supporting research projects
• Producing written materials, often (but not always) by adapting European templates
• Delivering presentations
• Understanding of, and liaison with, key media contacts
• Understanding of and experience in the field of cardiology
Выбор достойного The SFL National Project Coordinator/Manager, очевидно, очень
важно для успеха SFL в вашей стране. Несмотря на то, The SFL National Project
Coordinator/Manager не будет устанавливать свои цели и определять стратегию, он
или она будет нести ответственность за обеспечение того, чтобы стратегия
осуществлялась и задачи выполнялись. Роль координатора проекта будет включать в
себя некоторые или все из следующих элементов:
• Связь с и отчетности перед SFL Управляющим Комитетом
• Координация SFL партнерами, в том числе с SFL Рабочей Группой и ресурсами
находящимися в их распоряжении
• Предоставление административной поддержки SFL Чемпиону страны
• Набор дополнительных партнеров, а также обеспечение дополнительного
финансирования в случае необходимости
• Взаимодействие с третьими сторонами, включая правительство и группы пациентов
• Взаимодействие с SFL Европейским проект-менеджером, так и с другими The SFL
National Project Coordinator/Manager
• Поддержка научно-исследовательских проектов
• подготовка письменных материалов, часто (но не всегда), адаптируя европейские
шаблоны
• Предоставление презентаций
• Взаимодействие со СМИ
• Понимание и опыт в области кардиологии
The official language of the SFL, at least between countries and at the level of the European
Executive Board, is English. Therefore, good spoken and written English are essential to the role. It
is also essential that you select a person with a proactive, ‘can-do’ attitude, as the SFL National
Project Coordinator/Manager will be responsible for driving your projects on a day-to-day basis and
ensuring successful delivery.
Finding a person who can fulfil all of these requirements can be difficult. Good places to start
include:
• The SFL Task Force and local board members – have they worked with a project manager or
coordinator in the past who might be suitable?
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
10. Prepared March 2011
• SFL Industry and Advocacy partners – have they worked with anyone suitable? Do they have
someone suitable who can be seconded? Can their HR departments help? Can they include
a description of the job on the ‘vacancies’ page of their websites?
• Recruitment agencies that specialise in the healthcare sector
The SFL National Project Coordinator/Manager is not hired or contracted by the European Society of
Cardiology (ESC), but instead by the national SFL organisation.
Официальный язык SFL, по крайней мере, между странами, так и на уровне
Европейского Исполнительного Комитета является английский. Таким образом,
хороший разговорный и письменный английский язык необходимы для этой роли. Это
также важно, чтобы выбрать человека с активной позиции ", может, сделать, как The
SFL National Project Coordinator/Manager будет отвечать за ведение Государственного
(Регионального) Плана Внедрения SFL инициативы день за днем.
Найти человека, который может выполнить все эти требования может быть трудным.
Где искать:
• Рабочая группа SFL и рекомендуемые ей люди
• Среди партнеров SFL по индустрии и пропаганде, рекомендуемые ими люди
• Кадровые агентства, которые специализируются в сфере здравоохранения
The SFL National Project Coordinator/Manager не может быть нанят на работу
Европейским обществом кардиологов (ESC), но вместо этого может быть принят на
работу в национальные SFL организации.
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
11. Prepared March 2011
Situation Analysis and Strategic Planning
Getting Started
With your structure firmly in place and the right people on board, it is time to move your local SFL
initiative into the analysis and planning phase. Typically, this would involve the following steps:
• Mapping and analysing the local situation
• Identifying barriers to the use of p-PCI
• Developing a strategic plan to overcome those challenges
• Implementing that plan
This section will provide guidance and suggestions on how to proceed with each of these steps.
Начинается работа в рамках SFL инициативы с анализа ситуации и планирования
действий. Как правило, это будет включать в себя следующие этапы:
• Отображение и анализ локальной ситуации
• выявление препятствий к использованию р-PCI
• Разработка стратегического плана для преодоления этих проблем
• Осуществление этого плана
Этот раздел содержит рекомендации и предложения о том, как действовать с каждым
из этих шагов.
Mapping and Analysing Your Local Situation
A good understanding of the local p-PCI situation is obviously essential in order to devise strategies
to change and improve that situation. As a first step, the SFL Task Force should establish the
following pieces of information as accurately as possible:
• National and regional reperfusion rates
• National and regional mortality rates for AMI and ACS
• The number and location of p-PCI centres
• The number and location of 24/7 p-PCI centres
• The ratio of p-PCI centres to overall population
• Average time it takes for a patient to arrive at a p-PCI centre, and what kind of transportation
(e.g. ambulance, helicopter) is available
• What kind of equipment is available within ambulances (e.g. ECG equipment), and the level
of training of Emergency Services personnel
• The staff allocation for each centre, and what kind of training support staff (including nurses)
routinely receive
• The proportion of the population that is served by a p-PCI centre within a 90 minute travel
window
• The differences in service between different cities and different regions – where is the service
exemplary; where does it need improvement
• The number of interventional cardiologists per capita
• Additional details of relevance
Not all this information will be readily available, but it is likely the Task Force will be able to draw on
the resources of the SFL Steering Committee, Industry Partners and affiliated third party groups
(including the National Cardiology Society) to find much of the above. These data can be used to
build an accurate picture of what the p-PCI situation is in your country. We have created a template
table for you to complete with your relevant country details (see page 14).
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
12. Prepared March 2011
It is advised that you also use this data to produce an actual map of the p-PCI situation in your
country (network and coverage), as this will help all your stakeholders to better visualise the
challenges you face (see case study example, page 11).
We also recommend that you use the mapping exercise to identify p-PCI centres that you can
potentially partner with, either as examples of best practice that you can use for peer-to-peer
learning sessions with other centres, or to help them improve and upgrade the service they offer.
You may also want to highlight on your map which centres you are partnering with and the regions
where most support will be needed.
Identifying Barriers to the Use of PCI
Each country, once it has finished mapping out its p-PCI situation, must then identify the specific
barriers to effective reperfusion that exist in their country. These may include the following:
• Insufficient number or geographical spread of 24/7 cath labs, or sub-optimal staffing (possibly
due to insufficient funding or training)
• Delayed emergency service response, or inappropriate response, for example taking STEMI
patients to the nearest Emergency Room even though it doesn’t have a cath lab
• Emergency services are inadequately equipped, for example the ambulance does not have
ECG equipment as standard, or personnel are inadequately trained
• Low awareness of STEMI symptoms by patients and/or family, leading to delayed contact
with emergency services
We have developed a table for you to use to help map out your local country barriers (based on
patients, EMS, hospital and organisational) and the target end goals (see page 15).
Defining Objectives and Developing a Strategic Plan
Once the local p-PCI situation is mapped out and the barriers identified, you will be well-placed to set
your SFL objectives – referring to the overall SFL three-year objectives outlined in the introductory
letter at the beginning of this toolkit – and determine a strategy to achieve these, including a budget.
You may decide your priority is to develop a 24/7 p-PCI network to cover your entire country or to
focus initially on target regions/cities. It may be that the network is already in place, but that an
Emergency Services transportation protocol is required, so that ambulance drivers know to by-pass
the nearest Emergency Room in favour of the nearest 24/7 cath lab. You may also need to
implement data collection systems so that your progress can be monitored.
Once your strategic plan is complete, you will need to present it to the SFL Executive Board for
feedback and approval.
Publishing Your Findings
The objectives and strategy that you set will of course be determined by the unique circumstances in
your country, revealed by the mapping and analysis exercise. It is important that SFL is completely
open and transparent about its activities and objectives, and that all partners and stakeholders have
access to our research results and future plans. We therefore recommend that you write, present (at
your national cardiology congress) and publish (in your national cardiology journal) the results of
your country mapping exercise, the barriers identified and your proposed solution.
When publishing your findings, it is advised that this is always supported by the following mention:
‘The Stent for Life Initiative is a joint initiative between the European Association of Percutaneous
Cardiovascular Interventions (EAPCI), a registered branch of the European Society of Cardiology
(ESC), and EuroPCR.’
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
13. Prepared March 2011
Securing Budget
Implementing your strategic plan will obviously require funding. It is therefore necessary to secure
sufficient budget to carry out those plans. The most reliable sources of funding may include:
• SFL Industry Partners
• Your National Cardiac Society
• The larger, more influential patient groups
• Government – in particular the health department
Reaching out to all these groups, and any other that are relevant in your country, to secure funds is
obviously one of the key factors affecting success, and we encourage you to commit time, resources
and influential personnel to achieving this goal.
Monitoring Systems and Measuring Success
It will be important to be able to demonstrate success to your partners, funders and other
stakeholders, most importantly patients at risk of STEMI. It is recommended that you determine what
your local success will look like, and ways to measure this success, in this initial planning phase.
For example, if you decide to implement a consumer awareness campaign, you could consider
conducting market research before the launch of the campaign and then after a key milestone in
your campaign to determine if the campaign has had an impact on consumer understanding of the
symptoms of heart attack and the need to call an ambulance quickly.
Part of measuring success will also involve monitoring the progress of your local initiatives. The
exact nature of the monitoring system you adopt will depend on the unique circumstances within
your country. In some cases, you may already have a National p-PCI/STEMI Registry in place. If
not, you may want to consider adopting one, so that all cases of p-PCI/STEMI are logged on a
central database, including details such as the time from emergency call to catheterisation and any
time delay during the implementation of p-PCI.
Securing and Working with Industry Partners
Numerous Industry partners are already signed up to SFL on a central European level, and their
local affiliate companies are obviously natural partners in your country. Additionally, there may be
other potential partners in your country. When assessing a potential partner, it is important that they
are aligned with SFL’s goals, and also that they are willing to actively support those goals. This
support may include participating in defining strategy, as well as providing expertise such as project
management, local analysis, patient awareness, promotion, funding and investment planning. They
should not however, under any circumstances, influence the scientific content of the Initiative.
Administration
Reporting Results
It is important that the European SFL Steering Committee is kept up to date on the activities and
progress taking place in each of the SFL countries. To help facilitate this, we have developed a
reporting template (see page 16) which should be completed and emailed to Zuzana Kaifoszova
(kaifosz@gmail.com) a month in advance of the two main milestones – EuroPCR in May and ESC in
August – and at the end of the year (December).
Stent for Life Email Address
We recommend each country to set up a SFL group email address, which includes key country
contacts, to make it as simple as possible to contact a SFL country. The format that should be used
is as follows: stentforlife_countryname@...
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
14. Prepared March 2011
Analysis and Planning Case Study
This account of setting up an SFL initiative in the fictional state of Belovia provides an example
of the steps that should be taken when first setting up your local SFL initiative.
Belovia is a small land-locked country with a population of 6.5 million. More than half the
population live in the capital city, Reperfusia, but the mountainous regions in the North are
sparsely populated.
Belovia joined SFL in 2009, and quickly appointed its SFL Country Champion, Steering
Committee, Task Force and National Project Coordinator.
Under the guidance of the Country Champion and the Steering Committee, the Task Force
began the mapping process to analyse the p-PCI situation in their country. Key results
included the following:
• There are 6 national p-PCI centres that operate 24/7, that are potentially within 90
minutes of 85% of the population. However, p-PCI rates are less than 150/mil/year
• The average EMS arrival time is over 40 mins after a call is made and most ambulances
are not equipped with ECG, meaning that the majority of patients are transferred to the
nearest non-PCI hospital
• Ambulances responding to emergency calls from the mountainous north can take three
to four hours to arrive at a hospital, following which a transfer to a cath lab is often
required
• The older generations, who lived through the Belovia civil war, are very reluctant to
complain about their health, and many do not know the symptoms of STEMI
The Belovia SFL Initiative examined these and other data, and determined that their priority
objectives would be to:
• Greatly reduce the time taken for STEMI patients to present at a cath lab
• Educate consumers of all ages on the symptoms and consequences of STEMI
The local SFL team then decided upon the following strategies to achieve these objectives:
• Provide in-ambulance ECG and training for paramedics to ensure STEMI patients are
taken straight to the cath lab with as little delay as possible
• Raise funding and political will to provide a helicopter ambulance for the mountainous
region in the North
• Conduct a consumer awareness campaign to educate older people on the symptoms of
STEMI, and also to encourage their children and grandchildren to look after the hearts
of their loved ones
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
15. Prepared March 2011
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
16. Prepared March 2011
Stent for Life Initiative Action Checklist
Status
Action Delivery Date (completed/ongoing/
not-started)
Phase 1: Programme Launch
SFL Country Champion
Appointment
Letter of support from National
Society
SFL Steering Committee
Appointed
SFL Task Force Appointed
SFL National Project
Coordinator Appointed
Phase 2: Situation Analysis
Mapping the local situation
Draw map of local situation
Defining Barriers
Phase 3: Planning and Budget
Set three-year measurable
objectives
Define strategic approach
Develop tactical plan and
budget
Present plan to SFL Executive
Board
Publish plan and/or present it at
cardiology congress
Secure budget
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
17. Prepared March 2011
Stent for Life Initiative Country Situation
Country Detail Situation
Population
Country surface area
GDP per capita
No. of interventional cardiologists
Rate of AMI
Rate of AMI mortality
Usage rate of PCI
Usage rate of thrombolysis
Rate of no reperfusion therapy
PCI per million
p-PCI per million
% of p-PCI in STEMI patients
No. of cath labs
No. of 24/7 cath labs
Average distance to cath lab
No. of ambulances
Average no. of ambulances with ECG
Availability of helicopters Yes / No
No. of patients that call EMS
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
18. Prepared March 2011
Stent for Life Initiative Barriers
Barrier Goal Current Situation
Patient Related Barriers
EMS Related Barriers
Hospital Related Barriers
Organisational Related Barriers
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
19. Prepared March 2011
Stent for Life Initiative Reporting Template
Background Information
Country [Insert country]
Country Champion/ [Insert name]
Project Manager
[Insert list e.g. governmental figures, patient groups, industry
Key Partner Organisations
partners, etc]
Country Objectives •
Key Project Updates
Summarise any key updates [e.g. overall progress in achieving objectives, any meetings,
and/or progress you have made media campaigns, new partners, etc]
in the last 3-6 months, including
your key successes
Summarise any issues you have [e.g. lack of funding, resistance from policy makers, etc]
faced in the last 3-6 months
Next Steps
Summarise your key activities for [e.g. critical steps and progress in achieving objectives, etc]
the next 3-6 months
Key milestones and meetings [List any upcoming meetings and/or key milestones and their
timing]
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
20. Prepared March 2011
Stent for Life Initiative Reporting Template
Background Information
Country [Insert country]
Country Champion/ [Insert name]
Project Manager
[Insert list e.g. governmental figures, patient groups, industry
Key Partner Organisations
partners, etc]
Country Objectives •
Key Project Updates
Summarise any key updates [e.g. overall progress in achieving objectives, any meetings,
and/or progress you have made media campaigns, new partners, etc]
in the last 3-6 months, including
your key successes
Summarise any issues you have [e.g. lack of funding, resistance from policy makers, etc]
faced in the last 3-6 months
Next Steps
Summarise your key activities for [e.g. critical steps and progress in achieving objectives, etc]
the next 3-6 months
Key milestones and meetings [List any upcoming meetings and/or key milestones and their
timing]
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR
21. Prepared March 2011
Stent for Life Initiative Reporting Template
Background Information
Country [Insert country]
Country Champion/ [Insert name]
Project Manager
[Insert list e.g. governmental figures, patient groups, industry
Key Partner Organisations
partners, etc]
Country Objectives •
Key Project Updates
Summarise any key updates [e.g. overall progress in achieving objectives, any meetings,
and/or progress you have made media campaigns, new partners, etc]
in the last 3-6 months, including
your key successes
Summarise any issues you have [e.g. lack of funding, resistance from policy makers, etc]
faced in the last 3-6 months
Next Steps
Summarise your key activities for [e.g. critical steps and progress in achieving objectives, etc]
the next 3-6 months
Key milestones and meetings [List any upcoming meetings and/or key milestones and their
timing]
Stent for Life is a joint initiative between the European Association of Percutaneous Cardiovascular
Interventions (EAPCI), a registered branch of the European Society of Cardiology (ESC), and EuroPCR