Effectiveness of a multidisciplinary quality improvement initiative in reducing door-to-balloon times in primary angioplasty.
Primary angioplasty (PA) for acute myocardial infarction (AMI) has emerged as the standard of care in hospitals with cardiac interventional facilities. The benefits from the PA are time dependent, but recent data raise concerns regarding the timeliness of delivery of care in AMI and the level of benefit achieved by current standards. We assessed the effectiveness of an extensive multidisciplinary quality improvement initiative in reducing door-to-balloon (DTB) times in PA. The PA process was divided into six separate time periods, which were assessed individually. Subsequent quality initiatives resulted in a dramatic reduction in the mean DTB time (141.3 minutes preintervention compared to 95.1 minutes postintervention; P < 0.001).
Zarich
Stuart W
SW
Department of Internal Medicine(Cardiology), Bridgeport Hospital, Yale University School of Medicine, 267 Grant Street, Bridgeport, CT 06610, USA. pszari@bpthosp.org
Sachdeva
Rajesh
R
Fishman
Robert
R
Werdmann
Michael J
MJ
Parniawski
Margaret
M
Bernstein
Lawrence
L
Dilella
Michelle
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000592:standards* / Q000706:statistics & numerical data; D016507:Cardiology Service, Hospital / Q000592:standards*; D003237:Connecticut; D004562:Electrocardiography; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D015397:Program Evaluation; D011446:Prospective Studies; D013997:Time Factors; D013996:Time and Motion Studies; D017749:Total Quality Management / Q000458:organization & administration*