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Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
Processes to Decrease
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Processes to Decrease

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  • 1. Processes to Decrease Door-to-Balloon Times for STEMI Patients in a Community Hospital Sam Ward MD FACC, Pamela Goepfarth MBA RN-C, Mark Izzo MD FACC, William Mecca MD FACC, Wayne Jones DO, Joseph Cacchione MD FACC Saint Vincent Health Center Erie, Pennsylvania
  • 2. Background
    • Pre-hospital (EMS), Emergency Department (ED), and Cardiology/Cath Lab processes play key roles in reducing Door-to-Balloon (D2B) times
    • Our non-profit, community hospital has utilized the ACC/AHA STEMI guidelines of care since 2001 to triage and manage STEMI patients
  • 3. Methods
    • A multidisciplinary team divided D2B time into three primary intervals with specific targets
      • ED Door to 1st ECG time (5 minutes)
      • ED Door to Cath Lab Door time (60 minutes)
      • Cath Lab Door to Balloon Deployment time (20 minutes)
  • 4. ED Door to1st ECG time
    • Implementation of remote EMS 12-lead ECG transmission
    • Placement of a dedicated bed in ED Triage for stat ECGs
    • Trained ED staff to perform 12-lead ECGs
  • 5. ED Door to Cath Lab Door Time
    • Utilization of 24/7 in-hospital cardiology coverage resulting in 5-minute Cardiology response time when a STEMI alert (Code Heart Stat) is called by the ED
    • Activation of the cath lab team which prepares the cath lab and then goes immediately to the ED to expedite transporting the patient
  • 6. Cath Lab Door to Balloon Deployment Time
    • Utilizing high volume operators
    • Developing standardized protocols for angiography
  • 7. Additional General Methods
    • Ongoing data monitoring and immediate information feedback was a critical factor in reducing D2B time
  • 8. Results 276 Patients Evaluated
  • 9.  
  • 10.  
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  • 13. Conclusion
    • A systematic approach enhanced and made more stable by in-house cardiology along with real-time information feedback has helped reduce and maintain D2B time at  90 minutes
  • 14.  

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