Coronary artery diseaseDoor-to-Balloon Times in Hospitals Within the Get-With-The-Guidelines Registry After Initiation of the Door-to-Balloon (D2B) Alliance
Section snippets
Methods
The goals and rationale of the D2B Alliance have been recently described in detail.3 Briefly, it is a large quality improvement effort that was launched by the American College of Cardiology in partnership with several other health care organizations including the American Heart Association and the GTWG-CAD program. To date, the D2B Alliance has enrolled approximately 1,000 hospitals with a goal to achieve D2B times of ≤90 minutes for ≥75% of nontransferred patients with STEMI undergoing
Results
We identified 5,801 nontransferred patients with STEMI treated with primary PCI at 167 GWTG-CAD participating hospitals during the study period. Of these, 3,567 patients were treated at 98 hospitals that formally joined the D2B Alliance and 2,234 patients were treated at 69 hospitals that did not. Table 1, Table 2 present patients' clinical factors and performance measurements at GWTG-CAD participating hospitals, stratified by whether the patients were treated at hospitals that joined the D2B
Discussion
We found significant improvements in DTB times among GWTG-CAD participating hospitals, coinciding with the launch of the D2B Alliance. The primary target of DTB times within 90 minutes in ≥75% of patients established by the D2B Alliance was nearly reached among all GWTG-CAD participating hospitals, and the target was exceeded by the 98 GWTG-CAD participating hospitals that formally joined the D2B Alliance. This achievement is the culmination of a series of important events over the previous 5
Acknowledgment
We acknowledge the support of Louise Morgan, MSN, and the hospitals participating in the D2B Alliance and the GWTG programs, the American College of Cardiology, and the American Heart Association. We also thank Sally Ramon-English for her help with preparing the report.
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2015, Progress in Cardiovascular DiseasesThe impact of prehospital 12-lead electrocardiograms on door-to-balloon time in patients with st-elevation myocardial infarction
2014, Journal of Emergency NursingCitation Excerpt :The Centers for Medicare & Medicaid Services12 and The Joint Commission13 determined that a door-to-balloon time of less than 90 minutes should be the standard of care. In 2005 the ACC created the Door-to-Balloon: An Alliance for Quality initiative,14 advocating adoption of 6 key strategies to reduce door-to-balloon time: (1) an emergency physician activates the cardiac catheterization laboratory, (2) one call activates the cardiac catheterization laboratory, (3) the cardiac catheterization laboratory team is ready in 20 to 30 minutes, (4) prompt data feedback regarding the follow-up on the patient from the cardiac catheterization laboratory is provided to those in the emergency department who cared for the patient, (5) there is senior management commitment, and (6) a team-based approach is used in caring for the patient. Also in 2005 the AHA recommended more specific prehospital guidelines for chest pain patients15: (1) prehospital 12-lead ECG diagnostic programs in urban and suburban emergency medical services, (2) routine use of prehospital 12-lead ECGs and advanced notification for patients with signs and symptoms of acute coronary syndromes, (3) prehospital personnel's acquisition and transmission of either diagnostic-quality ECGs or their interpretation of them to the receiving hospital, and (4) advanced notification of the arrival of the patient with acute coronary syndromes.