Abstract 15968: Reducing Time to Intervention for ST-segment Elevation Myocardial Infarction Through Critical Care Transport
Objective: Several approaches have been utilized by transport programs to decrease the door-to-balloon (D2B) time for patients experiencing ST-segment elevation myocardial infarction (STEMI). The purpose of this presentation is to describe how one hospital-based Midwest critical care transport program implemented an acute care transfer line which allowed for a reduction of D2B times.
Method: The previous referral process, which consisted of 21 steps (mean 42 minutes, median 44 minutes, range 23–64 minutes) was reviewed to identify areas for improvement. An acute care transfer line was established and released to regional hospitals in the health system. The acute care transfer line provides a one call process for the referring physician who directly communicates with the transport coordinator – a critical care transport RN. The transport coordinator then activates the critical care transport team and catheterization lab. The team is autolaunched regardless of bed availability and without communication with an accepting physician. When the critical care transport team arrives at the referring hospital the ACNP evaluates the patient and confirms the diagnosis. Patients are then transported by rotor-wing or surface transport directly to the catheterization lab.
Outcomes: Prior to implementation of the hospital-based critical care transport team, the median D2B time was 185 minutes for 355 patients transferred from 37 hospitals from January 2002 through May 2007. Implementation of the hospital-based critical care transport team resulted in a reduction in the median D2B times to 119 minutes.
Conclusion: The implementation of a hospital-based critical care transport team facilitated the development of an acute care transfer line that has resulted in a reduction of D2B times for patients experiencing STEMI. Although the median D2B time is currently 119 minutes, further examination of each phase of the transport process is needed to further improve D2B times.
- © 2010 by American Heart Association, Inc.