Project UPSTART is a free, quality improvement program specifically developed to help hospitals decrease recognition to reperfusion time (R2R) in ST-Segment Myocardial Infarction (STEMI). UPSTART focuses on providing a standardized yet customizable approach to STEMI care that any hospital or network can easily adapt to their needs. It provides a “toolbox” of highly effective procedures, processes and strategies focused on improving the entire STEMI treatment process, not just segments. Integral to the process is accurate measurement of reperfusion times for all STEMI patients, even transfers. This provides the data essential to facilitating continued improvement. Focused on improving the process rather than the provider, UPSTART offers an efficient and systematic approach to excellence in STEMI care.