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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Staff Recall Travel Time for ST Elevation Myocardial Infarction Impacted by Traffic Congestion and Distance: A
Justin Cole1,2, Richard Beare2,3, Thanh G Phan4
1Peninsula Health Heart Service, Frankston, VIC, Australia.
Insights
Optimizing staff recall for percutaneous coronary intervention (PCI) requires considering traffic and distance. Mapping travel times helps predict optimal on-call residence for faster STEMI reperfusion.
Area of Science:
- Cardiology
- Health Services Research
- Geographic Information Systems
Background:
- Hospitals often miss guideline times for ST-elevation myocardial infarction (STEMI) percutaneous coronary intervention (PCI).
- Rapid catheter laboratory staff assembly is critical for meeting PCI time goals.
- Traffic congestion and travel distance impact staff recall times, affecting STEMI reperfusion.
Purpose of the Study:
- To create regional maps illustrating the impact of traffic and distance on staff recall travel times for STEMI.
- To develop a resource for improving STEMI reperfusion times by optimizing staff on-call residence.
Main Methods:
- Estimated staff travel times using Google Maps API for inner and outer metropolitan hospitals.
- Modeled travel times during midnight, 6 PM, and 7 AM to account for traffic variations.
- Overlaid computer predictions on metropolitan maps, color-coding travel times under peak and non-peak traffic.
Main Results:
- Inner metropolitan staff travel times were more affected by traffic congestion than outer metropolitan times.
- Outer metropolitan staff travel times were more influenced by distance.
- Peak hour travel times were significantly longer than midnight travel times for both hospital types.
- Fewer staff members could reach the hospital within 30 minutes during peak hours compared to midnight.
Conclusions:
- Integrating map software with traffic data, distance, and travel time aids in predicting optimal on-call staff residence.
- This approach can help improve reperfusion times for STEMI patients.
- Geospatial analysis provides a valuable tool for optimizing emergency medical response logistics.
Background:
Recent evidence suggests hospitals fail to meet guideline specified time to percutaneous coronary intervention (PCI) for a proportion of ST elevation myocardial infarction (STEMI) presentations. Implicit in achieving this time is the rapid assembly of crucial catheter laboratory staff. As a proof-of-concept, we set out to create regional maps that graphically show the impact of traffic congestion and distance to destination on staff recall travel times for STEMI, thereby producing a resource that could be used by staff to improve reperfusion time for STEMI.
Methods:
Travel times for staff recalled to one inner and one outer metropolitan hospital at midnight, 6 p.m., and 7 a.m. were estimated using Google Maps Application Programming Interface. Computer modeling predictions were overlaid on metropolitan maps showing color coded staff recall travel times for STEMI, occurring within non-peak and peak hour traffic congestion times.
Results:
Inner metropolitan hospital staff recall travel times were more affected by traffic congestion compared with outer metropolitan times, and the latter was more affected by distance. The estimated mean travel times to hospital during peak hour were greater than midnight travel times by 13.4 min to the inner and 6.0 min to the outer metropolitan hospital at 6 p.m. (p < 0.001). At 7 a.m., the mean difference was 9.5 min to the inner and 3.6 min to the outer metropolitan hospital (p < 0.001). Only 45% of inner metropolitan staff were predicted to arrive within 30 min at 6 p.m. compared with 100% at midnight (p < 0.001), and 56% of outer metropolitan staff at 6 p.m. (p = 0.021).
Conclusion:
Our results show that integration of map software with traffic congestion data, distance to destination and travel time can predict optimal residence of staff when on-call for PCI.
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