O Gara et al 2013 ACCF/AHA STEMI Guideline e401 improved communication among physicians, nurses, and pharmacists; medication reconciliation; careful transitions between care settings; and consistent documentation. The National Quality Forum also has endorsed a set of patient- centered Preferred Practices for Care Coordination, 619 which detail comprehensive specifications that are necessary to achieve the goals of successful care coordination for patients and their families. Systems of care designed to support patients with STEMI and other cardiac diseases can result in signifi- cant improvement in patient outcomes. To provide the inter- ventions and services listed in Table 14, appropriate resources must be applied to ensure that all patients with STEMI have full access to evidence-based therapies and follow-up care. There is a growing emphasis on penalizing hospitals for avoid- able hospital readmissions. Hence, it is imperative for health systems to work in partnership with physicians, nurses, phar- macists, communities, payers, and public agencies to support the interventions that achieve such comprehensive care. Patient characteristics may be important predictors of read- mission after MI; however, only a few variables have been From a policy perspective, a vali- dated risk-standardized model that uses readmission rates to profile hospitals is not currently available. 12. Unresolved Issues and Future Research Directions The writing committee has identified several areas pertain- ing to the management of patients with STEMI that deserve further research. Although the observations from the Swedish STEMI registry showing an association between the increased use of evidence-based treatments and declining mortality rates after STEMI are encouraging,18 additional efforts to improve patient outcomes are needed. 