Numerator Patients with acute STEMI (or its equivalent*) defined by characteristic symptoms of myocardial ischemia with diagnostic ST elevation on ECG, who are transferred to a PCI-capable hospital and have received primary PCI 120 min from FMC *Patients with STEMI equivalent on ECG may have: hyperacute T-wave changes, true posterior MI, multilead ST depression with coexistent ST elevation in lead aVR, characteristic diagnostic criteria in the setting of LBBB. Denominator All patients with acute STEMI, or its equivalent, who are seen initially at non PCI-capable hospital and who are transferred to a PCI-capable hospital and have received primary PCI Denominator Exclusions Patients age <18 y Patients who are transferred for a PCI that is described as nonprimary by a healthcare provider (eg, patients who receive fibrinolytic therapy at the referral facility as the primary reperfusion therapy) Denominator Exceptions Documentation of a medical reason for the delay (eg, cardiopulmonary arrest, balloon pump insertion, respiratory failure requiring intubation) Documentation of a patient reason for the delay (eg, initial patient concern) Patient currently enrolled in a clinical trial related to STEMI and reperfusion therapy Measurement Period Encounter Sources of Data Medical record or other database (eg, administrative, clinical, registry) Attribution Measure reportable at the facility* level *Both STEMI referral facility (non PCI-capable) and STEMI receiving facility (PCI-capable) are accountable for this measure. Care Setting Inpatient Rationale Patient outcome is improved if patients, initially presenting to a non PCI-capable hospital, can be quickly transferred to a PCI-capable hospital for Clinical Recommendation(s) 2013 ACCF/AHA Guideline for the Management of Patients With ST-Elevation Myocardial Infarction12 1. 