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AHA: Door-to-Balloon Time Reduction Strategies Examined

Researchers identify six effective strategies, but find that most hospitals aren't using them

MONDAY, Nov. 13 (HealthDay News) -- In managing heart attack patients with ST-segment elevation, several hospital strategies can reduce door-to-balloon time, but few hospitals use them to meet the gold standard of 90 minutes or less, according to a report released online Nov. 13 and published in the Nov. 30 issue of the New England Journal of Medicine.

Elizabeth H. Bradley, Ph.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues surveyed 365 hospitals.

The researchers identified six effective strategies: emergency medicine physicians activate the catheterization laboratory (mean reduction, 8.2 minutes); a single call to a central page operator activates the laboratory (13.8 minutes); the emergency department activates the catheterization laboratory while the patient is en route to the hospital (15.4 minutes); the staff arrives in the catheterization laboratory within 20 minutes of being paged (19.3 minutes); an attending cardiologist is always on site (14.6 minutes); and emergency department and catheterization laboratory staff use real-time data feedback (8.6 minutes).

"It is now time to act," conclude the authors of an accompanying editorial. "The Centers for Medicare and Medicaid Services, the American College of Cardiology, the American Heart Association, the National Quality Forum, and many other public and private groups are aligned to move forward with efforts to improve the time to reperfusion."

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