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Contemporary evidence: baseline data from the D2B Alliance.
Elizabeth H Bradley1, Brahmajee K Nallamothu, Amy F Stern
1Section of Health Policy and Administration, School of Public Health, Yale University School of Medicine, New Haven, Connecticut, USA. elizabeth.bradley@yale.edu
BMC Research Notes
|August 20, 2008
Summary
Many hospitals struggle to meet guidelines for prompt ST-segment elevation myocardial infarction (STEMI) treatment. A 2007 study found few hospitals fully implemented key Door-to-Balloon (D2B) strategies, indicating room for improvement in STEMI care.
Area of Science:
- Cardiology
- Health Services Research
- Quality Improvement
Background:
- Less than 50% of U.S. hospitals meet guidelines for prompt ST-segment elevation myocardial infarction (STEMI) treatment.
- The Door-to-Balloon (D2B) Alliance aims to improve STEMI care through evidence-based strategies.
- This study assesses the prevalence of these strategies and associated hospital characteristics.
Purpose of the Study:
- To determine the prevalence of key evidence-based strategies for reducing Door-to-Balloon (D2B) time in U.S. hospitals participating in the D2B Alliance.
- To identify hospital characteristics associated with the implementation of these STEMI treatment strategies.
Main Methods:
- A cross-sectional study surveyed 797 U.S. hospitals within the D2B Alliance via a web-based questionnaire.
- Practices for STEMI patients receiving primary percutaneous coronary intervention (PCI) were assessed.
- Multivariate logistic regression identified hospital characteristics linked to strategy use.
Main Results:
- Only 30.4% of surveyed hospitals utilized at least 4 of 5 key D2B strategies in 2007.
- 9.3% of hospitals employed none of the critical strategies.
- No clear correlation was found between hospital characteristics and the reported use of strategies.
Conclusions:
- In 2007, a significant number of hospitals had adopted few key strategies to shorten D2B times.
- There is substantial opportunity to enhance STEMI patient care by increasing the adoption of these evidence-based strategies.
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