title: Optimization of door-to-electrocardiogram time within a critical pathway for the management of acute coronary syndromes at a teaching hospital in Colombia.
abstract: BACKGROUND
  Door-to-electrocardiogram (D2E) time is recognized as one of the quality parameters in the attention of acute coronary syndromes. Electrocardiogram realization within periods below 10 minutes increases the possibility to achieve quick and effective reperfusion, which has an impact on outcomes.
  
  
  OBJECTIVE
  To describe the results of a strategy whose goal is to improve the fulfillment of the D2E deadline below 10 minutes in adults who attend the emergency service due to chest pain with clinical suspicion of acute coronary syndromes.
  
  
  METHODS
  Before-and-after study that assesses D2E time upon the implementation of actions for the reorganization of the process of attention of the patients with chest pain within the context of the implementation of a critical pathway.
  
  
  RESULTS
  A total of 373 patients were assessed, 204 in the before stage and 169 in the after stage. The median D2E time was 16 minutes in the before stage, in 41% of the cases it was below 10 minutes; upon the implementation of the change in the process of attention of chest pain the median was 5 minutes, with 63% of the cases below 10 minutes, exhibiting a statistically significant difference.
  
  
  CONCLUSIONS
  The actions taken led to a lower median of D2E time and a higher percentage of patients with times below 10 minutes. However, further interventions are required to assure a higher number of patients with D2E times below 10 minutes.
authors: From the *Division of Research, Department of Internal Medicine, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia and †Department of Physiological Sciences, Universidad Nacional de Colombia, Bogotá, Colombia.
authors: John Jaime
authors: JJ
authors: Sprockel
authors: Lina Paola
authors: LP
authors: Tovar Diaz
authors: Olga Paola
authors: OP
authors: Omaña Orduz
authors: Miguel Angel
authors: MA
authors: Saavedra
authors: Walter Gabriel
authors: WG
authors: Chaves Santiago
authors: Juan José
authors: JJ
authors: Diaztagle Fernández
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003105:Colombia / Q000453:epidemiology; D019091:Critical Pathways / Q000592:standards*; D019468:Disease Management; D004562:Electrocardiography / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome