Abstract
Purposes
The objective of this study was to evaluate the effectiveness of a streamlined interfacility
referral protocol in reducing door-to-balloon (D2B) times for patients experiencing
acute ST-segment elevation myocardial infarction (STEMI).
Basic Procedures
In a retrospective database review, we compared D2B times for patients requiring interfacility
transfer after the implementation of a streamlined referral protocol. All patients
undergoing interfacility transport with a referring diagnosis of STEMI were eligible
for inclusion. Quality management databases were reviewed by trained abstractors using
standardized data entry forms for D2B times from July 2009 through June 2010. Median
D2B times with interquartile ranges are reported.
Main Findings
A total of 133 patients exhibited complete data and were included in the analysis,
54 of which were transferred via the streamlined referral protocol. Streamlined referral
patients exhibited a median D2B time of 101 minutes (interquartile range, 88-128)
vs a median D2B time of 122 minutes (interquartile range, 99-157) for the traditional
referral group (P = .001). Door-to-balloon times of 90 minutes or less were achieved in 13% of the
traditional referral patients and in 30% of the streamlined protocol group (odds ratio,
2.9; 95% confidence interval, 1.2-7).
Principal Conclusion
The implementation of a streamlined referral protocol has significantly reduced D2B
times for patients diagnosed with STEMI that required interfacility transport for
intervention.
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Article Info
Publication History
Published online: January 23, 2013
Accepted:
September 28,
2012
Received in revised form:
September 28,
2012
Received:
September 7,
2012
Footnotes
☆Prior presentations: Critical Care Transport Medicine Conference, Nashville, TN, April 2 to 4, 2012.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
