Abstract 18259: A Novel Approach to Address Door-to-ECG Time for Walk-In Patients by Training Non-Medical Staff to Recognize Symptoms of Possible Acute Coronary Syndrome
Problem: The ACTION Registry®--GWTG™ Dashboard revealed in previous studies that triage personnel are having difficulty identifying when to perform an appropriate ECG in the recommended 10 minute time frame. Those studies showed that 80% of the missed ECG’s were walk-in patients whose first point-of-contact was registration or security. We have since used this information to implement a novel approach to decrease the time between presentation and 1st ECG completion for patients with ACS symptoms.
Methods: A pilot training program was developed and aimed at registration and security staff. Six, 1 hour classes trained all 84 Emergency Department (ED) auxiliary staff to focus on risk factors and clinical symptoms of ACS using specific case studies. A five question post-test was given to gauge understanding and retention. Class participants also completed a survey highlighting what they learned, enjoyed, and how to improve the course.
Results: All of the participants passed the 5 question post-test focusing on ACS recognition and appropriate action. Eighty-five percent reported that they now feel comfortable in identifying MI symptoms. Fifteen percent of the course participants reported feeling gratification at being a member of the healthcare team with an increased sense of empowerment. All participants were offered an additional web-based training regarding STEMI’s and 10% have volunteered to observe a cardiac catheterization in their free time. The triage personnel course participants have overwhelmingly requested more sessions or yearly classes as the course’s only improvement.
Conclusions: This program demonstrates that non-medical staff can be trained to quickly recognize symptoms concerning for ACS which can expedite evaluation and treatment. This program has the potential to improve door-to-ECG times and in addition increases morale. Anecdotally, a registration staff member has already identified a patient and facilitated an ECG within 7 minutes who was quickly identified to be having a STEMI. This program could be a model for other departments across the country to successfully improve patient care with the additional benefit of increasing departmental morale.
- © 2013 by American Heart Association, Inc.