title: Accelerated management of patients with ST-segment elevation myocardial infarction in the ED.
abstract: OBJECTIVE
  The objective of this study was to evaluate improvement opportunities in the emergency department for timely ST-segment elevation myocardial infarction management and evaluated the new process flow.
  
  
  METHODS
  In a prospective study, we compared time from door to cath laboratory before and after implementation of a new ST-segment elevation myocardial infarction (STEMI) protocol. The new protocol included a blend of strategies to reduce door to cath laboratory time.
  
  
  RESULTS
  We included 55 patients. After implementing a new STEMI protocol, we included 54 patients. Time to cath laboratory was 21 (interquartile range, 9-40) minutes before and 10 (interquartile range 5-25) minutes after initiation of the new protocol (P = .02). A door to cath laboratory time less than 15 minutes was reached in 36% of our patients in phase 1 and in 61% in phase 2 (odds ratio; 0.36, 95% confidence interval, 0.16-0.81; P = .01).
  
  
  CONCLUSIONS
  Simple changes in organizational strategies resulted in a significantly faster care for patients with acute uncomplicated STEMI.
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Christof
authors.initials: C
authors.lastname: Havel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schreiber
authors.forename: Günter
authors.initials: G
authors.lastname: Christ
authors.forename: Susanne
authors.initials: S
authors.lastname: Winkler
authors.forename: Harald
authors.initials: H
authors.lastname: Herkner
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D017598:Efficiency, Organizational; D004562:Electrocardiography; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors