title: Improving door-to-balloon times in primary percutaneous coronary intervention for acute ST-elevation myocardial infarction: the value of an audit-driven quality initiative.
abstract: 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).
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, Singapore. rabindcharles@yahoo.com.sg
authors.forename: Rabind A
authors.initials: RA
authors.lastname: Charles
authors.forename: Shiou Liang
authors.initials: SL
authors.lastname: Wee
authors.forename: Bernard W K
authors.initials: BW
authors.lastname: Kwok
authors.forename: Caren
authors.initials: C
authors.lastname: Tan
authors.forename: Swee Han
authors.initials: SH
authors.lastname: Lim
authors.forename: Venkataraman
authors.initials: V
authors.lastname: Anantharaman
authors.forename: Wasantha
authors.initials: W
authors.lastname: Hemanthakumari
authors.forename: Terrance S J
authors.initials: TS
authors.lastname: Chua
mesh_terms: 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