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AMI ‘D2B’ – Rapid Review and Improvement
The Problem
The early use of primary angioplasty in patients with acute myocardial
infarction who present with ST-segment elevation or LBBB results in a
significant reduction in mortality and morbidity. The earlier primary coronary
intervention is provided, the more effective it is (Brodie, 1998 and DeLuca,
2004). National guidelines recommend the prompt initiation of PCI in patients
presenting with ST-elevation myocardial infarction (Antman, 2004). Initiation of
intervention is dependent on clinical staff communication between the
Emergency Department and the Cardiac Cath Lab. The AMI D2B measure is
used to assess care processes, decision making and team-based
communication related to this important intervention.
The Interventions
Realtime notification via ED Omnicell to D2B Team based on pull
of STEMI Meds.
Chronologic review and documentation provided to ED/CathLab
Clinicians within 24-48 hours of event by HCQ, allowing timely
feedback to involved clinical staff.
Monthly Team Meeting reviews process segments and outliers.
Focus on process/system analysis ‘to root’ - Noted process
improvements include:
Improving patient triage & rapid ECG
More rapid/direct activation of cath lab
More rapid transport from ED to Cath Lab
Aim/Goal
Improve collaboration and communication between departments to ensure:
Prompt data feedback – realtime/close to realtime review of outliers to
identify process failures and need for change
Protocols/Expected Time Frames for Assessment are known
One Call Activation of CathLab;
Leadership/Senior management commitment
The Team
Cardiac Cath Lab Physicians and Nursing
Emergency Medicine Physicians & Nursing
Health Care Quality Process Improvement–Director /Data Abstractors
Progress to Date
PCI Within 90 minutes
Percent of Patients
Increase the use of evidence-based strategies to improve an interdepartmental
alliance and coordination of care between the ED and Cath Lab related to
STEMI D2B times aiming to ensure >75% D2B time < 90 minutes.(ACC D2B
Alliance).
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
FY06‐Q4
FY07‐Q1
FY07‐Q2
FY07‐Q3
FY07‐Q4
For More Information Contact
Kathy Murray, Director Process Improvement HCQ
Ann Potwin, QI Data Abstractor, HCQ
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Silverman Symposium
Description
An account of the resource
Each year the Silverman Symposium poster session offers BIDMC staff and affiliates the opportunity to share experiences and learn about efforts to improve Quality and Safety.
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Silverman Poster
Primary Contact
If you would like more information about this project, contact this person. Make email address clickable.
Kathy Murray (<a href="mailto:kmurray2@bidmc.harvard.edu">kmurray2@bidmc.harvard.edu</a>)<br /> Ann Potwin (<a href="mailto:apotwin@bidmc.harvard.edu">apotwin@bidmc.harvard.edu</a>)
Project Team
Cardiac Cath Lab Physicians and Nursing<br /> Emergency Medicine Physicians & Nursing<br />Health Care Quality Process Improvement–Director /Data Abstractors
Department
Any departments listed on the poster or identified in the spreadsheet.
Nursing
Medicine
Emergency Medicine
Health Care Quality and Safety
BIDMC Location
The BIDMC location where the poster team resides if identified in spreadsheet. If not identified, choose BIDMC.
BIDMC
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
AMI ‘D2B’ – Rapid Review and Improvement -2006-2007
Date
A point or period of time associated with an event in the lifecycle of the resource
2006-2007
Format
The file format, physical medium, or dimensions of the resource
pdf
Compliance
Effectiveness
Efficiency
Safety
Timeliness