Improving door-to-balloon times in primary percutaneous coronary intervention for acute ST-elevation myocardial infarction: the value of an audit-driven quality initiative.
BACKGROUND
The study was designed to reduce door-to-balloon times in primary percutaneous coronary intervention for patients presenting to the Emergency Department with acute ST-elevation myocardial infarction, using an audit as a quality initiative.


METHODS
A multidisciplinary work group performed a pilot study over 3 months, then implemented various process and work-flow strategies to improve overall door-to-balloon times.


CONCLUSIONS
We developed a guideline-based, institution-specific written protocol for triaging and managing patients who present to the Emergency Department with symptoms suggestive of STEMI, resulting in shortened median door-to-balloon times from 130.5 to 109.5 minutes (P<0.001).
Charles
Rabind A
RA
Department of Emergency Medicine, Singapore General Hospital, Singapore. rabindcharles@yahoo.com.sg
Wee
Shiou Liang
SL
Kwok
Bernard W K
BW
Tan
Caren
C
Lim
Swee Han
SH
Anantharaman
Venkataraman
V
Hemanthakumari
Wasantha
W
Chua
Terrance S J
TS
D015906:Angioplasty, Balloon, Coronary; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008485:Medical Audit; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D016730:Program Development; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012846:Singapore; D013997:Time Factors; D014218:Triage