2022 Quality Summit ePosters (Non-CE) - Chest Pain-MI Registry-10. United to Improve Metric #37 First Medical Contact -Device Time

10. United to Improve Metric #37 First Medical Contact -Device Time

Pdf Summary

Two hospitals within the Indiana University Health (IUH) system, Hospital A and Hospital B, experienced a decline in Metric #37, which measures first medical contact (FMC) to device time for heart attack patients. To address this issue, both hospitals implemented strategies to mitigate delays in electrocardiogram (ECG) transmission and STEMI activation.<br /><br />At Hospital B, a focus team consisting of various stakeholders met regularly to review FMC to device case outliers and identify issues with ECG transmissions. They discovered failed ECG transmissions and the lack of alerts when ECGs were delivered. The team created a plan to activate STEMI cases even if the ECG was not transmitted, recognizing the importance of early activation. Cancelled cases were reviewed in detail. As a result, Hospital B saw an increase in Metric #37 performance from 66.7% in Q4 2021 to 92.3% in Q2 2022.<br /><br />Hospital A also formed a focus team to investigate barriers to STEMI activation. They identified the activation of the STEMI call team after patient arrival to the ED as a common issue. To address delays in ECG to activation, the hospital researched EMS ECG transmission capabilities and explored external programs for transmitting ECGs from EMS to the ED. They also reevaluated internal STEMI pathways and implemented interventions to improve ED activation processes. This led to an increase in Metric #37 performance from 66.7% in Q3 2020 to 85.7% in Q2 2022.<br /><br />Both hospitals emphasize the importance of improving Metric #37 FMC-device time as it is publicly reported and reflects their commitment to acute myocardial infarction care. They also plan to continue monitoring ECG to STEMI activation times and explore new external technologies for facilitating EMS ECG transmission.<br /><br />In conclusion, the implementation of strategies to mitigate ECG to activation delays improved Metric #37 performance at Hospital A and Hospital B. The shared discussions and collaboration between the hospitals' multidisciplinary teams enabled transparent conversations and the identification of breakdowns in the ECG to STEMI activation processes. Both hospitals will continue to work towards improving this metric and providing high-quality care for heart attack patients.

Keywords

Indiana University Health

Metric #37

FMC to device time

heart attack patients

ECG transmission

STEMI activation

focus team

early activation

Q2 2022

acute myocardial infarction care