CHICAGO — At the heart of the new national campaign to reduce hospital door-to-balloon times for patients with ST-elevation MI undergoing primary percutaneous intervention is a tool kit designed to help participating hospitals boost performance.
“It's simple, easy to implement, concise, and spans a number of different processes in the hospital that we need to improve,” Dr. Wayne B. Batchelor explained at the annual scientific sessions of the American Heart Association.
Dr. Batchelor, an interventional cardiologist at Tallahassee (Fla.) Memorial Hospital who helped develop the tool kit, knows from firsthand experience that it works. “We found when we implemented these changes that our door-to-balloon times came down from around 110 minutes to… 75–80 minutes. And we've seen with that a 36% drop in mortality in the space of about a year,” he said. “We've also seen the proportion of ST-elevation MI patients who undergo primary PCI rise from about one-half to 95%–100% very quickly. … We've shaved more than a day off our median length of stay simply by getting patients treated earlier,” Dr. Batchelor added.
Dr. Harlan M. Krumholz, chair of the Guidelines Applied in Practice-Door-to-Balloon (GAP-D2B) Working Group, said he knows of hospitals that have gotten their door-to-balloon times down into the 60− to 70-minute range using the key strategies promoted in the GAP-D2B campaign.
The GAP-D2B initiative is an example of a new, more proactive paradigm for translating potentially lifesaving academic research into clinical practice, added Dr. Krumholz, professor of medicine at Yale University, New Haven, Conn.
The campaign launch was tied to the release of a major study that provides evidence of the specific steps integral to getting D2B times of 90 minutes or less as recommended in national guidelines (see p. 1). “We're not going to be happy unless this campaign changes practice in the next 12 months,” he said.