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Streamlined Systems Mean Faster Care
for Heart Attack PatientsTime is of the essence in detecting and treating a heart attack. One critical measure of heart care is “door-to-balloon time,” a marker of how quickly a team is able to get blood flowing again in patients who have had a cardiac event. Door to balloon time is counted from the time patients hit the “door” to the point when they get balloon angioplasty to open the heart artery.
Standards-setting organizations in healthcare have set the target for door-to-balloon time at 90 minutes. Froedtert & the Medical College of Wisconsin now have the bar set at 60 minutes. “Based on our median times, we’ve clearly surpassed the 90-minute goal,” David Marks, MD, said. Dr. Marks is a Medical College of Wisconsin interventional cardiologist and director of the Cardiac Catheterization Laboratory. “We have a large team focusing on this issue,” he said, “optimizing systems and providing state-of-the-art care.”
One key in shrinking door-to-balloon time is accurate, to-the-minute monitoring, made easier by satellite clocks installed around the facility to prevent reporting discrepancies. As an academic medical center, Froedtert & the Medical College of Wisconsin are equipped to systematically analyze the data.
“We use a Six Sigma process to look at our times and variances, so we know where to direct resources,” Dr. Marks said. Six Sigma is a highly demanding quality-control system initiated at Motorola and honed at GE.
To speed diagnosis, paramedics send EKG test results from the field to an emergency room physician, who activates the catheterization lab where cardiac interventionalists do balloon angioplasty or place stents. They do this with a one-call paging system and without time-consuming consultation with a cardiologist. The streamlined system alerts the cardiac intervention team to be ready when patients come in or are referred from hospitals that aren’t fully equipped.
The depth of resources at Froedtert & the Medical College of Wisconsin means faster door-to-balloon times. “We have dedicated interventionalists and cath teams who take care of this specific issue. It’s our job to do it well,” Dr. Marks said. “Yet, it is important to understand door to balloon times are not risk adjusted: obviously, sicker patients will take more time.” And, facilities define door-to-balloon times differently. “Consumers must use caution in interpreting this data,” Dr. Marks added. “An integrated process of quality improvement and standardized reporting will make the difference in patient care.”
Source: Froedtert Today Date: June 2006 | Medical Reviewer: | David Marks, MD | | Medical College of Wisconsin interventional cardiologist | | Director, Cardiac Catheterization Laboratory |
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