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A STEMI code protocol improves door-to-balloon time on weekdays and weekends

Nidal Abi Rafeh1, Dina Abi-Fadel, Robert V Wetz

  • 1Department of Medicine, Staten Island University Hospital, Staten Island, NY, USA.

Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
|December 5, 2009
PubMed

Insights

Implementing a STEMI Code protocol significantly improved door-to-balloon times for ST-elevation myocardial infarction (STEMI) patients receiving percutaneous coronary intervention (PCI). This protocol reduced disparities in care between weekdays and weekends.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Systems Research

Background:

  • Primary percutaneous coronary intervention (PCI) is the standard treatment for ST-elevation myocardial infarction (STEMI).
  • Door-to-balloon (DTB) times for STEMI patients often exceed the recommended 90 minutes, impacting outcomes.
  • Significant disparities exist in DTB times between weekday and weekend STEMI care.

Purpose of the Study:

  • To evaluate the impact of a STEMI Code protocol on DTB times.
  • To assess whether the protocol reduced disparities in PCI delivery between weekdays and weekends.

Main Methods:

  • A retrospective review of STEMI cases before and after STEMI Code protocol implementation.
  • Analysis of door-to-balloon times for patients receiving primary PCI.
  • Comparison of DTB times based on weekday versus weekend presentation.

Main Results:

  • The STEMI Code protocol led to a threefold increase in patients receiving PCI within 90 minutes (p<.0001).
  • Pre-protocol, only 27.1% of weekday and 6.3% of weekend STEMI cases met the 90-minute DTB goal.
  • Post-protocol, DTB times significantly improved, equalizing weekday and weekend care.

Conclusions:

  • A STEMI Code protocol is highly effective in improving DTB times for STEMI patients.
  • The protocol successfully mitigated disparities in timely PCI access between weekdays and weekends.
  • Implementation of such protocols is crucial for optimizing STEMI management and patient outcomes.

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