Multicentre analysis of current ST-elevation myocardial infarction acute care pathways
| Autor: | Cordula Wagner, Carolien de Blok, J. Tra, Ineke van der Wulp, Martine C. de Bruijne |
|---|---|
| Přispěvatelé: | Public and occupational health, APH - Quality of Care, APH - Methodology, SOM OPERA |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Remote patient monitoring medicine.medical_treatment Best practice emergency care patient monitoring MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD) health personnel attitude Acute care consultation Medicine ST segment Myocardial infarction human cardiovascular diseases catheterization ST segment elevation myocardial infarction business.industry therapy delay practice guideline percutaneous coronary intervention article Percutaneous coronary intervention medical information QUALITATIVE RESEARCH medicine.disease Conventional PCI diagnostic accuracy Medical emergency Cardiology and Cardiovascular Medicine business Health Care Delivery Economics and Global Health Care Qualitative research |
| Zdroj: | Open Heart, 4(1):e000458. BMJ Publishing Group Open Heart, 4(1):e000458. BMJ PUBLISHING GROUP Tra, J, de Blok, C, Van Der Wulp, I, De Bruijne, M C & Wagner, C 2017, ' Multicentre analysis of current ST-elevation myocardial infarction acute care pathways ', Open Heart, vol. 4, no. 1, e000458 . https://doi.org/10.1136/openhrt-2016-000458 Open Heart |
| ISSN: | 2053-3624 |
| DOI: | 10.1136/openhrt-2016-000458 |
| Popis: | Background: Rapid reperfusion with percutaneous coronary intervention (PCI) is vital for patients with ST segment elevation myocardial infarction (STEMI). However, the guideline-recommended time targets are regularly exceeded. The goal of this study was to gain insight into how Dutch PCI centres try to achieve these time targets by comparing their care processes with one another and with the European guidelinerecommended process. In addition, accelerating factors perceived by care providers were identified. Methods: In this multiple case study, interviews with STEMI care providers were conducted, transcribed and used to create process descriptions per centre. Analyses consisted of within-case and between-case analyses of the processes. Accelerating factors were identified by means of open and axial coding. Results: In total, 28 interviews were conducted in six PCI centres. The centres differed from the guidelinerecommended process on, for example, additional, unavoidable patient routings and monitoring delays, and from one another on the communication of diagnostic information (eg, transmitting all, only ambiguous or no ECGs) and catheterisation room preparation. These differences indicated diverging choices to maintain a balance between speed and diagnostic accuracy. Factors perceived by care providers as accelerating the process included trust in the tentative diagnosis, and avoiding unnecessary intercaregiver consultations. The combination of processes and accelerating factors were summarised in a model. Conclusions: Numerous differences in processes between PCI centres were identified. Several timesaving strategies were applied by PCI centres, however, in different configurations. To further improve the care for patients with STEMI, best practices can be shared between centres and countries. |
| Databáze: | OpenAIRE |
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