title: Improvement in door-to-balloon (D2B) time in acute ST-elevation myocardial infarction through the D2B alliance--experience of 15 primary percutaneous coronary intervention centers in Taiwan.
abstract: BACKGROUND
  Currently, the door-to-balloon (D2B) times observed in clinical practice in Taiwan are different from those recommended by evidence-based guidelines. D2B Alliance, a countrywide initiative for quality supported by the Taiwan Joint Commission on Hospital Accreditation, sought to achieve the goal of administering treatment to 75% of patients with ST-elevation myocardial infarction (STEMI) within 90min of hospital presentation.
  
  
  RESULTS
  The current study was designed to be prospective, national, and multicenter. We conducted a longitudinal study of the D2B times recorded in 15 primary percutaneous coronary intervention centers and examined the changes caused by implementing the D2B Alliance strategies. A total of 1,726 patients were enrolled in the D2B Alliance and implementation of the D2B Alliance strategies resulted in a significant decrease in the average D2B times (128.8 ± 42.9 min vs. 83.2 ± 16.2 min; P<0.001) from those at baseline. By the end of the year-long study, the percentage of patients treated under 90 min had increased from 46.2% to 80.1% in the hospitals enrolled in the D2B Alliance.
  
  
  CONCLUSIONS
  Over the 1 year, hospitals enrolled in the D2B Alliance achieved the goal of reducing the D2B times of 75% of STEMI patients to less than 90 min.
authors.affiliation: Graduate Instituate of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Su-Kiat
authors.initials: SK
authors.lastname: Chua
authors.forename: Jun-Jack
authors.initials: JJ
authors.lastname: Cheng
authors.forename: Kou-Gi
authors.initials: KG
authors.lastname: Shyu
authors.forename: Jen-Yuan
authors.initials: JY
authors.lastname: Kuo
authors.forename: Yu-Lin
authors.initials: YL
authors.lastname: Ko
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Wang
authors.forename: Kuan-Cheng
authors.initials: KC
authors.lastname: Chang
authors.forename: Po-Ming
authors.initials: PM
authors.lastname: Ku
authors.forename: Shih-Huang
authors.initials: SH
authors.lastname: Lee
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data*; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D011446:Prospective Studies; D058996:Quality Improvement / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D013624:Taiwan / Q000453:epidemiology; D061665:Time-to-Treatment / Q000592:standards / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data