A quality improvement project to reduce door-to-electrocardiogram time: A multicenter study

Area of Science:

• Emergency Medicine
• Quality Improvement Science
• Cardiology

Background:

• Timely electrocardiograms (EKGs) are crucial for diagnosing acute coronary syndrome (ACS).
• Achieving a target door-to-EKG time of 10 minutes or less is a key performance indicator in emergency departments (EDs).
• Previous compliance rates for this target were suboptimal, necessitating quality improvement efforts.

Purpose of the Study:

• To enhance compliance with a 10-minute door-to-EKG time for patients presenting with ACS symptoms.
• To evaluate the effectiveness of targeted quality improvement interventions in a real-world clinical setting.

Main Methods:

• A pre-post study design was implemented across five EDs in Saudi Arabia from January 2014 to May 2016.
• Quality improvement interventions included optimizing staffing, providing education, upgrading technology, and fostering interdepartmental collaboration.
• Multivariate analysis was employed to assess factors influencing door-to-EKG times.

Main Results:

• A total of 11,518 patients underwent EKG during the study period.
• Pre-intervention compliance with the 10-minute door-to-EKG goal was 62.6%.
• Post-intervention compliance significantly improved to 87.7%. Male patients showed a higher likelihood of receiving timely EKGs.

Conclusions:

• Quality improvement projects are effective in increasing the percentage of patients receiving EKGs within 10 minutes of ED arrival.
• The study highlights the success of multifaceted interventions in improving critical care pathways.
• Further research is needed to establish the clinical significance and patient outcomes associated with reduced door-to-EKG times.