Prince Sultan Cardiac Center - Qassim (PSCCQ) is a 50-bedded tertiary care Cardiology Institute, located in central Saudi Arabian province of Al Qassim., offering clinical, interventional, and surgical services.

PSCCQ is the only primary Percutaneous Coronary Intervention (PCI) center, for the entire Qassim region, a province spread over geographic area of about 60,000 square kilometers with population of 1.3 million. PSCCQ is equipped with two state-of-the-art Cardiac catheterization suites, operational round-the-clock,with 24/7 Cardiac surgery backup 

PSCCQ is the only primary PCI-capable center in Qassim province. With ever-increasing incidence of Coronary artery disease, it’s been a real challenge to keep up with the pace of rising demand for Coronary angioplasties. STEMI (ST elevation Myocardial infarction) patients across the region are immediately brought into PSCCQ through primary PCI protocol and undergo emergent Coronary interventions. 

The NSTE-ACS (non ST elevation acute Coronary syndrome) patients which include NSTEMI (non ST elevation Myocardial infarction) and unstable Angina., had to wait several days at referring hospitals to come in for Coronary angiography at PSCCQ. While the Cath Labs at PSCCQ can accommodate all-comers, the delay in Coronary revascularization for NSTE-ACS patients was bed unavailability. This is when the clinical model of care for timely management of NSTEC-ACS patients called CAPASITY (Coronary Angioplasty Procedure and Safely Immediate Transfer-back Yielding) was conceptualized

(Coronary Angioplasty Procedure and Safely Immediate Transfer-back Yielding), a hub-and-spokes network model of care for NSTE-ACS patients all over the Qassim province, is implemented since mid-2023. CAPASITY, with it’s motto “revascularize in time”,  aims to minimize the wait times for NSTE-ACS patients across the region to undergo the crucial Coronary angiography procedure, and in most instances the very life-saving Coronary angioplasties, at PSCCQ (hub). A critical aim post PCI, is safe and immediate transfer back to referring hospital (spoke), with close inpatient remote monitoring and care supervision at the spoke, from the hub, and early PCI clinic follow-up. CAPASITY is also aimed at maximizing the utilization of Cardiac catheterization services at PSCCQ, whilst freeing up beds at this premier Cardiology institute to serve patients indicated for specialized Cardiac care. The objectives of this enterprise include improved patient prognosis, increased patient throughput, and patient satisfaction

Responsibility begins at the referring hospitals, which are distributed throughout the  Qassim region. These hospitals initially own the responsibility for:

 Detecting signs of Non-ST-Elevation Acute Coronary Syndrome  

                         (NSTE-ACS) in patients and providing initial stabilization measures.

  Performing necessary preliminary assessments and
           confirming the NSTE-ACS diagnosis to determine the need for further specialized intervention.

-Arranging the safe transfer of patients to PSCCQ for advanced diagnostics and treatment, including preparing medical documentation and ensuring clear communication about the patient's current status and medical history.

Once patients are transferred to PSCCQ and arrive at KFSH-ER, the responsibility    shifts to PSCCQ, the hub of the CAPASITY initiative, which takes on several critical roles.

Conducting detailed diagnostics such as coronary angiography and, if necessary, performing PCI.

Post-procedure, PSCCQ evaluates patients to decide whether they can be safely transferred back to their referring hospital or if they should remain at PSCCQ for further care based on clinical criteria outlined in the  reverse triage policy.

 In cases where patients are transferred back, PSCCQ continues to provide remote monitoring and specialist support to ensure ongoing care continuity and address any complications that may arise.

Following the patient's treatment at PSCCQ

Once a patient is deemed stable and meets the criteria for reverse triage, responsibility is transferred back to the referring hospital along with detailed documentation of the treatment provided and specific follow-up care instructions.

  Patients who meet criteria for safe referral back and sent back to referring hospitals. The telemedicine unit at PSCCQ will oversee the monitoring of post-PCI patients at the referring hospital until their discharge, ensuring patient is discharged on guideline-directed medical therapy with post-PCI clinic appointment at PSCCQ.

   For the patients being sent back to referring hospital, the escort team shall be briefed on procedural details, post procedure care, and follow-up plan.

    A detailed report with angiographic findings, interventions performed, medication and risk-factor control recommendations, and PCI clinic follow-up appointment request shall be provided to the Escort team.

   The ACS Coordinator must maintain communication and follow-up while en route until the patient reaches the referring hospital.

  The telemedicine unit at PSCCQ will oversee the monitoring of post-PCI patients at the referring hospital until their discharge, ensuring patient is discharged on guideline-directed medical therapy with post-PCI clinic appointment at PSCCQ.

policy need for final approval