Thank you for viewing the Chest Pain MI Registry December case scenario regarding metric 55, door-in, door-out time. In this scenario, a 75-year-old female with a past medical history of hypertension and cigarette use presented to Hospital A at 10 a.m. for complaints of chest pain. An ECG revealed STEMI and transport to the nearest PCI facility was arranged. The patient left Hospital A at 1045 a.m. via ambulance and arrived at Hospital B at 1115 a.m. PCI was performed to a proximal LED lesion at 1145 a.m. Is Hospital B's dashboard functioning as expected for metric 55, door-in, door-out time? 1. No. 2. Yes. Please take a moment to review to determine if Hospital B's dashboard is functioning as expected for metric 55, door-in, door-out time. And the answer is No. 2, Yes. The patient is not included in the denominator for metric 55, door-in, door-out time, therefore there is no data to report. To review, the denominator includes pre-admit STEMIs, sequence 12447, who were transferred for primary PCI, sequence 12415. Hospital B did not transfer the patient for primary PCI, rather they were the receiving facility. This metric is reporting for transferring facilities only. Now some of you may be asking, but why? Well, located in the Executive Summary Measures and Metrics Companion Guide Version 3 Resource Document, there are clinical rationales and or recommendations for each metric to aid in comprehension. For metric 55, clinical trials have demonstrated improved outcomes for patients with STEMI who were transferred to a primary PCI hospital in a timely manner. Current guidelines recommend that transfer occur immediately with an overall goal of first medical contact to device time of 120 minutes or less, which can be achieved by shortening the time in the first ED and transferring the STEMI patient with door-in, door-out time of 30 minutes or less. Thank you for viewing the Chest Pain MI Registry Monthly Case Scenario.

metric 55

door-in, door-out time

Chest Pain MI Registry

STEMI

timely transfer for STEMI patients