Sustaining Improvement in Door-to-Balloon Time Over 4 Years
| Autor: | Amit Noheria, Charanjit S. Rihal, Choon Chern Lim, Malcolm R. Bell, Wyatt W. Decker, David R. Holmes, Ryan J. Lennon, Latha G. Stead, Lori N. Scanlan-Hanson, David M. Nestler, Henry H. Ting, Luis H. Haro |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Performance feedback
medicine.medical_specialty business.industry medicine.medical_treatment Percutaneous coronary intervention Process changes medicine.disease Interquartile range St elevation myocardial infarction Emergency medicine medicine Door-to-balloon Myocardial infarction Cardiology and Cardiovascular Medicine Intensive care medicine business Cardiac catheterization |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 2:508-513 |
| ISSN: | 1941-7705 1941-7713 |
| DOI: | 10.1161/circoutcomes.108.839225 |
| Popis: | Background— American College of Cardiology/American Heart Association guidelines recommend a door-to-balloon time (DTB) Methods and Results— The Mayo Clinic STEMI protocol was implemented in April 2004 and included activation of the cardiac catheterization laboratory by the emergency medicine physician; a single call system to activate the catheterization laboratory; catheterization laboratory staff arrival within 20 to 30 minutes of activation; and real-time performance feedback within 24 to 48 hours. Data were collected on nontransferred STEMI patients. The preimplementation group (June 2002 to March 2004) comprised 96 patients with a median DTB of 97 (interquartile range, 82, 130) minutes, and 40% had a DTB P P =0.41). Conclusions— The Mayo Clinic STEMI protocol implemented strategies to reduce DTB for nontransferred patients with STEMI. DTB was significantly reduced, and the results were sustained over the 4-year follow-up period. Our experience demonstrates the effectiveness and durability of process changes targeting timeliness of primary percutaneous coronary intervention. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|