Door-to-Balloon Times in Hospitals Within the Get-With-The-Guidelines Registry After Initiation of the Door-to-Balloon (D2B) Alliance

Nallamothu, Brahmajee K.; Krumholz, Harlan M.; Peterson, Eric D.; Pan, Wenqin; Bradley, Elizabeth H.; Stern, Amy F.; Masoudi, Frederick A.; Janicke, David M.; Hernandez, Adrian F.; Cannon, Christopher P.; Fonarow, Gregg C.

doi:10.1016/j.amjcard.2008.12.030

Cited by 63 publications

(30 citation statements)

References 9 publications

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“…In 2007, the guidelines called for a FMCTB of less than 90 minutes for patients with STEMI, with first medical contact being defined as EMS arrival for patients calling 911. 18 As most centers have achieved DTB of 90 minutes in 75% of patients with STEMI, 22 prehospital transport time and delay are gaining increasing importance and focus. To encourage rapid FMCTB, guidelines noted "an underutilized but effective strategy for improving systems of care for STEMI patients is to expand the use of prehospital 12-lead ECG programs by EMS that provide advanced life support."…”

Section: Discussionmentioning

confidence: 99%

Impact of Prehospital Electrocardiogram Protocol and Immediate Catheterization Team Activation for Patients With ST-Elevation–Myocardial Infarction

Nestler

White

Rihal

et al. 2011

Circ: Cardiovascular Quality and Outcomes

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Section: Discussionmentioning

confidence: 99%

Impact of Prehospital Electrocardiogram Protocol and Immediate Catheterization Team Activation for Patients With ST-Elevation–Myocardial Infarction

Nestler

White

Rihal

et al. 2011

Circ: Cardiovascular Quality and Outcomes

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“…The D2B time was specifically defined as the number of minutes from hospital arrival to first balloon inflation, thrombus aspiration or device deployment to establish reperfusion. 19 This research was completed using surveys of hospitals that administered PPCI and submitted publicly available data to the Taiwan Joint Commission on Hospital Accreditation. In order to improve the D2B times in the 15 participating PPCI centers, a variety of learning processes derived from a breakthrough series model and evidence-based methods were implemented.…”

Section: Data Collection and Measuresmentioning

confidence: 99%

“…Several recent studies have examined the effectiveness of the formation of a D2B Alliance in reducing the D2B times to less than 90 min in STEMI. [19][20][21] Those studies have found marked changes in both the practice…”

mentioning

confidence: 99%

Improvement in Door-to-Balloon (D2B) Time in Acute ST-Elevation Myocardial Infarction Through the D2B Alliance

Chua

Cheng

Shyu

et al. 2013

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp atients with acute ST-segment elevation myocardial infarction (STEMI) require quick and efficient reperfusion treatment. The time from arrival at the hospital to percutaneous coronary intervention (PCI) for the infract-related artery, the so-called "door-to-balloon (D2B) time", is associated with the clinical outcome of patients. 1-7 Clinical practice guidelines recommend that STEMI patients receive primary PCI (PPCI) as soon as possible, and definitely within 90 min. 8-10 For the full realization of the benefits of PPCI in STEMI, an improved system needs to be established to decrease the total D2B time. In recent times, various innovations and key strategies have been shown to be associated with short D2B times. 11-14 Despite the implementation of such strategies, studies published hitherto, 15-17 except for a few, 18 indicate that only approximately 50% of STEMI patients receive PPCI within the recommended 90-min D2B time. Many patients do not receive prompt PPCI, and some of the institutions participating in the studies have shown that underuse of strategies is associated with longer D2B times. Several recent studies have examined the effectiveness of the formation of a D2B Alliance in reducing the D2B times to less than 90 min in STEMI. 19-21 Those studies have found marked changes in both the practice Background: Currently, the door-to-balloon (D2B) times observed in clinical practice in Taiwan are different from those recommended by evidence-based guidelines. D2B Alliance, a countrywide initiative for quality supported by the Taiwan Joint Commission on Hospital Accreditation, sought to achieve the goal of administering treatment to 75% of patients with ST-elevation myocardial infarction (STEMI) within 90 min of hospital presentation.

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“…1 Although voluntary national registries in the United States have shown that among patients with STEMI who undergo interhospital transfer, only 10% achieve a door-to-balloon time within 90 minutes, 8 national initiatives have focused primarily on improvement in the timeliness of reperfusion in hospital centers that perform primary PCI. 9,10 However, for patients requiring interhospital transfer for primary PCI, streamlined systems of care and integration of resources in the community are needed to effectively deliver timesensitive treatment. 11,12 Refining the systems to rapidly identify, triage, and transfer patients with STEMI presenting to non-PCI-capable hospitals is an important element of state and local regionalization initiatives for STEMI care.…”

mentioning

confidence: 99%

Getting In and Out

Nedeljkovic

Jacobs

2011

Circ: Cardiovascular Quality and Outcomes

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Door-to-Balloon Times in Hospitals Within the Get-With-The-Guidelines Registry After Initiation of the Door-to-Balloon (D2B) Alliance

Cited by 63 publications

References 9 publications

Impact of Prehospital Electrocardiogram Protocol and Immediate Catheterization Team Activation for Patients With ST-Elevation–Myocardial Infarction

Impact of Prehospital Electrocardiogram Protocol and Immediate Catheterization Team Activation for Patients With ST-Elevation–Myocardial Infarction

Improvement in Door-to-Balloon (D2B) Time in Acute ST-Elevation Myocardial Infarction Through the D2B Alliance

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