Emergency Department greeters reduce door-to-ECG time

Screening for Acute Coronary Syndrome in chest pain patients can be initiated with a 12-lead electrocardiogram (ECG). Current American College of Cardiology/American Heart Association guidelines recommends getting an ECG performed and reviewed within 10 minutes of the time these patients present to the Emergency Department (ED). One innovative method to improve door-to-ECG time is by placing a trained greeter in the triage section of the ED.

This study was conducted over a 3-week period from September to October 2006, in a large urban academic medical center. The greeter was stationed in the triage area, and screened every patient entering the ED for the following symptoms/complaints: chest pain, shortness of breath, acute mental status changes in nursing home patients, dizziness, and nausea with or without vomiting in diabetic patients. The greeter obtained the ECG in the qualified patients, or alerted the triage. Data was collected on ECGs for all ED patients who presented with the above complaints in the absence of a greeter.

In the 3 weeks of the study, data was collected on 126 cases. The greeter had obtained 40 ECGs, and 86 ECGs were done without the greeter. The average door-to-ECG times were significantly different between the groups. The study found 8.8 minutes in the greeter group versus 29.6 minutes in the nongreeter group (P = 0.000).

ED triage greeter can be effectively used to obtain timely ECGs in suspected Acute Coronary Syndrome patients.