Primary Percutaneous Coronary Intervention for Patients Presenting With ST-Segment Elevation Myocardial Infarction: Process Improvement in a Rural ST-Segment Elevation Myocardial Infarction Receiving Center

Autor: John F. Robb, John R. Butterly, Norman N. Yanofsky, John E. Jayne, Donald F. Guadagni, Nathaniel W. Niles, Jeremiah R. Brown, Jean A. Proehl, Sheila M. Conley, Tamara A. Anderson, Rayson C. Yang, Pantila Vanichakarn
Rok vydání: 2010
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Myocardial Infarction
Health Services Accessibility
Regional Health Planning
Electrocardiography
Internal medicine
medicine
Humans
New Hampshire
ST segment
Prospective Studies
Registries
cardiovascular diseases
Myocardial infarction
Angioplasty
Balloon
Coronary
Program Development
Aged
Quality of Health Care
Patient Care Team
Evidence-Based Medicine
Delivery of Health Care
Integrated
business.industry
ST elevation
Percutaneous coronary intervention
Emergency department
Middle Aged
medicine.disease
Organizational Innovation
Outcome and Process Assessment
Health Care
Transportation of Patients
Treatment Outcome
Practice Guidelines as Topic
Door-to-balloon
Cardiology
Female
Rural Health Services
Myocardial infarction diagnosis
Emergency Service
Hospital
Cardiology and Cardiovascular Medicine
business
TIMI
Program Evaluation
Zdroj: Progress in Cardiovascular Diseases. 53:202-209
ISSN: 0033-0620
Popis: Background Rural ST-segment elevation myocardial infarction (STEMI) care networks may be particularly disadvantaged in achieving a door-to-balloon time (D2B) of less than or equal to 90 minutes recommended in current guidelines. ST-Elevation Myocardial Infarction Process Upgrade Project A multidisciplinary STEMI process upgrade group at a rural percutaneous coronary intervention center implemented evidence-based strategies to reduce time to electrocardiogram (ECG) and D2B, including catheterization laboratory activation triggered by either a prehospital ECG demonstrating STEMI or an emergency department physician diagnosing STEMI, single-call catheterization laboratory activation, catheterization laboratory response time less than or equal to 30 minutes, and prompt data feedback. Evaluating success An ongoing regional STEMI registry was used to collect process time intervals, including time to ECG and D2B, in a consecutive series of STEMI patients presenting before (group 1) and after (group 2) strategy implementation. Significant reductions in time to first ECG in the emergency department and D2B were seen in group 2 compared with group 1. Conclusions Important improvement in the process of acute STEMI patient care was accomplished in the rural percutaneous coronary intervention center setting by implementing evidence-based strategies.
Databáze: OpenAIRE
Externí odkaz: