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The Importance of STEMI Door-to-Balloon Time

ESO Staff

Hospitals and EMS agencies alike have long associated the rate of positive outcomes for certain patients with the rate at which he or she received treatment. And while some of these time-based metrics have undergone shifting and revision over the years (for example, in the case of acute stroke patients), it’s clear that time-to-care benchmarks help providers prioritize cases, perform with the appropriate sense of urgency, and track the quality of care given to their patients.

The 90-Minute Goal

One of the most commonly tracked metrics relates to the arrival of an ST-Elevation Myocardial Infarction (STEMI) patient to the ED, to when he or she receives a Percutaneous Coronary Intervention (PCI) or a balloon angioplasty. It’s widely agreed that this procedure is most effective when conducted within a 90-minute time frame, before permanent damage to the heart has occurred.

Organizations like the D2B Alliance were formed specifically to increase percentages of patients receiving proper STEMI treatment within the 90-minute timeframe. The organization, which started in the U.S. in 2006, now works with hospitals around the world to share toolkits and systematic processes of care to help achieve the 90-minute benchmark.

Getting More Specific

Interestingly, as time has passed since the first focus on door-to-balloon times, the metrics for hospitals and EMS agencies have evolved to be more specific. For example, concept of “medical contact-to-balloon time” has been emphasized, recognizing the fact that STEMI may first be diagnosed in the transporting ambulance, rather than just upon arrival at the ED. Additionally, because balloon angioplasty is no longer always the first intervention performed, the term has further evolved to “medical contact-to-device time.”

The 90-minute window continues to serve as an important standard for healthcare providers. And while the clock is always ticking when it comes to STEMI cases, providers also recognize the importance of a complete diagnostic angiography of the entire coronary arterial system when possible. Results may dictate what kind of support will be needed for the intervention, and what strategy is most appropriate.

Metrics Are Key to Care

STEMI and stroke are just two of the interventions where success relies heavily on time to treatment. However, correlations can be found for other treatment rates and overall performance metrics for hospitals. Benchmarks and metrics can also help reduce sentinel events by ensuring best practices are consistently followed in every procedure. Additionally, many grants and accreditation processes require substantial metrics to prove quality of care.

Patient satisfaction and outcomes can also be improved by reviewing treatment along the entire spectrum of patient care. Many hospitals today are including data from their EMS partners to gain more insight into clinical and operational outcomes, volumes, times, and more. EMS data also plays a part in Joint Commission compliance, which includes two standards aimed at improving patient care by ensuring patient records are complete and comprehensive.

Better Data Exchange Along the Spectrum of Care

Hospitals today can take advantage of easy-to-use software tools designed to help share data with their EMS partners more easily and more securely. This data can be quickly and easily shared bidirectionally, analyzed, and reported out for a wide range of purposes. Hospitals and EMS agencies alike can use this data to perform comparative analysis, increase operational efficiency, measure and improve patient outcomes, and more.

Learn more about the full suite of software tools for Hospitals at eso.com/hospital.

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