Figure 1
Flow chart of patient participants.
Table 1
Fidelity of implementation of the MIMIC intervention in the KCMC ED, 2023–2024.
| FIDELITY MEASURE | DENOMINATOR | TOTAL N | OBSERVED N | % |
|---|---|---|---|---|
| Proportion of participants with chest pain/dyspnea correctly flagged the “AMI Suspect” triage card | Patient participants with AMI symptoms | 577 | 453 | 78.5% |
| Proportion of physicians observed to have ever brought their pocket cards to work | ED physicians | 22 | 22 | 100% |
| Proportion of ED staff starting the online training module | Total number of ED physicians and nurses | 54 | 45 | 83% |
| Proportion of ED physicians starting the online training module | Total number of ED physicians | 22 | 20 | 91% |
| Proportion of ED nurses starting the online training module | Total number of ED nurses | 32 | 25 | 78% |
| Proportion of participants with AMI receiving the educational pamphlet in the ED | Total number of patient participants with confirmed AMI | 141 | 53 | 38% |
Figure 2
Monthly fidelity outcomes over the study period (September 2023–August 2024).
Table 2
Penetration‑related findings.
| PENETRATION MEASURE | DENOMINATOR | TOTAL N | OBSERVED N | % |
|---|---|---|---|---|
| Proportion of nurses working in triage directly observed to use the “AMI suspect” triage card | Discrete nurse triage‑shift observations | 851 | 572 | 67.2% |
| Proportion of physicians directly observed to have their pocket cards at work | Discrete physician‑shift observations | 1910 | 1835 | 96.1% |
| Proportion of ED providers completing the online training module | All ED staff | 54 | 41 | 76% |
| Proportion of ED physicians completing the online training module | All ED physicians | 22 | 20 | 91% |
| Proportion of ED nurses completing the online training module | All ED nurses | 32 | 21 | 66% |
| Proportion of surviving participants with AMI who read the educational pamphlet within 30 days | AMI patients who received the educational pamphlet and survived to 30 days | 39 | 22 | 56% |
Table 3
Financial cost summary of MIMIC implementation for 12 months.
| EXPENSE | TSH | USD |
|---|---|---|
| Champion stipends (One physician and one nurse for 12 mo.) | 2,400,000 | $1,044.50 |
| Printing triage cards (50 printed and laminated) | 62,500 | $27.20 |
| Printing pocket cards (140 printed and laminated) | 145,000 | $64.10 |
| Printing certificates (4 printed) | 8,000 | $3.48 |
| Printing educational pamphlets (280 printed) | 425,000 | $184.96 |
| Building the online module (8 hours) | 330,900 | $144.00 |
| Total cost of implementation: | 3,371,400 | $1,468.24 |