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July 6, 2011Catheterization and Cardiovascular Interventions

Quality improvement in the door‐to‐balloon times for ST‐elevation myocardial infarction patients presenting without chest pain

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Why the study?

Does expanding indications for rapid ECG triage reduce door-to-balloon times in STEMI patients presenting without chest pain?

Population

131 ST-elevation myocardial infarction patients admitted through the emergency department who underwent…

Comparison

Quality improvement initiative mandating rapid… vs Standard triage protocol before the quality…

Design

Cohort

Authors

WBWilliam B. BordenMFMichelle M. FennessyAOAnne O’Connor

Discussion

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Overview

Broadening ECG triage protocols may accelerate STEMI care for atypical presentations; leaves open whether.

Structured PICO

Does expanding indications for rapid ECG triage reduce door-to-balloon times in STEMI patients presenting without chest pain?

P
Population
131 ST-elevation myocardial infarction (STEMI) patients admitted through the emergency department who underwent percutaneous coronary intervention (PCI) (69 in Phase I, 62 in Phase II)
I
Intervention
Quality improvement initiative mandating rapid electrocardiogram (ECG) triage for an expanded list of presenting symptoms (Phase II; July 2007-October 2009)
C
Comparator
Standard triage protocol before the quality improvement effort (Phase I; October 2004-June 2007)
O
Outcome
Door-to-balloon (DTB) time and time to first ECG (ECG interval)surrogate

Expanding indications for rapid ECG triage significantly reduces door-to-balloon times for STEMI patients presenting with atypical symptoms.

Cite This Study

Borden et al. (2011) studied this question.

synapsesocial.com/papers/6a8564c0734852141cd4cbb2https://doi.org/10.1002/ccd.23221
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Systems-Based Improvement in Door-to-Balloon Times at a Large Urban Teaching Hospital2009 · 32 citations
  2. 2An analysis of door‐to‐balloon time in a single center to determine causes of delay and possibilities for improvement2007 · 26 citations
  3. 3Strategies for Reducing the Door-to-Balloon Time in Acute Myocardial Infarction2006 · 845 citations
  4. 4Delays to reperfusion therapy in acute ST-segment elevation myocardial infarction: results from the AMI-QUEBEC Study2006 · 39 citations
  5. 5Relationship of Symptom-Onset-to-Balloon Time and Door-to-Balloon Time With Mortality in Patients Undergoing Angioplasty for Acute Myocardial Infarction2000 · 1,229 citations