Abstract
Poster presentation
Session C presented Monday, September 30, 1:00-2:00 pm
Purpose: Coronary heart disease accounts for 1 in 7 deaths in the US. killing more than 366,800 people annually. Kentucky is ranked 47th highest for heart disease and 43rd for cardiovascular deaths. Through the hospital's participation in a Leadership Saves Lives program, it was discovered there was fragmented communication between teams involved in STEMI care causing delays. The objective of the project was to meet the AHA Guidelines for improving care for STEMI patients by reducing first medical contact to device time to under 90 minutes first by implementing strategies for early identification of acute myocardial infarction (AMI) patients. Key to this initiative was partnering with key stakeholders and staff at all levels to effect change.
Design: This was a staff driven initiative based on feedback from all disciplines to improve quality and safety. A new app was being developed that would help to streamline our process starting with EMS, to arrival in the Emergency department, through to the cath lab. The pilot was successful. We moved forward and regionalized the process for over 30 EMS agencies that transport to our facility.
Setting: The setting spans the healthcare continuum and includes EMS all the way through to definitive cath lab care.
Participants/Subjects: The participants include all pre-hospital patients experiencing a ST Elevation myocardial infarction that present to the emergency department by EMS. EMS, emergency room staff /physicians, cath lab staff and cardiology physicians were all active participants in this project.
Methods: Variables include, First Medical Contact -to-balloon and door-to-balloon times. A team was formed and gathered data to identify actions to be implemented to achieve the goals. One goal was to streamline the flow of information from EMS through new technology. This facility is the only hospital in the region to implement an app based technology to accelerate time to treatment for the AMI patient to improve patient outcomes. This innovative technology begins at the point of EMS interaction, sends a picture of the EKG to the hospital, activates the care team, and is a universal timer for all of the data points such as time to EKG and door to balloon. The EKG and patient information are directly transmitted to the cardiologist and the cath lab team within minutes. We evaluated the process by measuring FMC-to-balloon and door-to-balloon times before and after implementation of the app.
Results/Outcomes: The data includes patients that arrive to the emergency department by EMS only. After implementation, the average FMC-to-balloon time decreased to 84 minutes, a 17% reduction. Prior to implementation only 54% of FMC-to-balloon were less than 90 minutes, that number increased to 69%. Prior to implementation, 78% of door-to-balloon times of patients arriving per EMS, were less than 90 minutes. That number has now increased to 98%.
Implications: Through innovation, communication was streamlined throughout the system for a seamless process. Early notification gives nursing time to prepare for the AMI patient prior to their arrival. By utilizing the Pulsara technology, there is real time interaction between all disciplines saving critical minutes when time is heart muscle.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Innovation, Collaboration, Quality
Recommended Citation
Eckart, Heather A. and Stiner, Danielle, "Using technology to transform STEMI care" (2020). General Submissions: Presenations (Oral and Poster). 145.
https://www.sigmarepository.org/gen_sub_presentations/2019/posters/145
Conference Name
Emergency Nursing 2019
Conference Host
Emergency Nurses Association
Conference Location
Austin, Texas, USA
Conference Year
2019
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Using technology to transform STEMI care
Austin, Texas, USA
Poster presentation
Session C presented Monday, September 30, 1:00-2:00 pm
Purpose: Coronary heart disease accounts for 1 in 7 deaths in the US. killing more than 366,800 people annually. Kentucky is ranked 47th highest for heart disease and 43rd for cardiovascular deaths. Through the hospital's participation in a Leadership Saves Lives program, it was discovered there was fragmented communication between teams involved in STEMI care causing delays. The objective of the project was to meet the AHA Guidelines for improving care for STEMI patients by reducing first medical contact to device time to under 90 minutes first by implementing strategies for early identification of acute myocardial infarction (AMI) patients. Key to this initiative was partnering with key stakeholders and staff at all levels to effect change.
Design: This was a staff driven initiative based on feedback from all disciplines to improve quality and safety. A new app was being developed that would help to streamline our process starting with EMS, to arrival in the Emergency department, through to the cath lab. The pilot was successful. We moved forward and regionalized the process for over 30 EMS agencies that transport to our facility.
Setting: The setting spans the healthcare continuum and includes EMS all the way through to definitive cath lab care.
Participants/Subjects: The participants include all pre-hospital patients experiencing a ST Elevation myocardial infarction that present to the emergency department by EMS. EMS, emergency room staff /physicians, cath lab staff and cardiology physicians were all active participants in this project.
Methods: Variables include, First Medical Contact -to-balloon and door-to-balloon times. A team was formed and gathered data to identify actions to be implemented to achieve the goals. One goal was to streamline the flow of information from EMS through new technology. This facility is the only hospital in the region to implement an app based technology to accelerate time to treatment for the AMI patient to improve patient outcomes. This innovative technology begins at the point of EMS interaction, sends a picture of the EKG to the hospital, activates the care team, and is a universal timer for all of the data points such as time to EKG and door to balloon. The EKG and patient information are directly transmitted to the cardiologist and the cath lab team within minutes. We evaluated the process by measuring FMC-to-balloon and door-to-balloon times before and after implementation of the app.
Results/Outcomes: The data includes patients that arrive to the emergency department by EMS only. After implementation, the average FMC-to-balloon time decreased to 84 minutes, a 17% reduction. Prior to implementation only 54% of FMC-to-balloon were less than 90 minutes, that number increased to 69%. Prior to implementation, 78% of door-to-balloon times of patients arriving per EMS, were less than 90 minutes. That number has now increased to 98%.
Implications: Through innovation, communication was streamlined throughout the system for a seamless process. Early notification gives nursing time to prepare for the AMI patient prior to their arrival. By utilizing the Pulsara technology, there is real time interaction between all disciplines saving critical minutes when time is heart muscle.