Processes to Decrease
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Processes to Decrease Presentation Transcript

  • 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
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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.