Improving D2B – We’re Killing It and Saving Lives! - 2025 Quality Summit Presentation (Non-CE)-Improving D2B

Video Transcription

Video Summary

Dr. Schimmel and nurse manager Rebecca Ratzke from Northwestern discuss the critical quality metric of door-to-balloon time in STEMI (heart attack) care, emphasizing that timely PCI (percutaneous coronary intervention) significantly reduces mortality. They outline the historical benchmarks—90 minutes has become the national standard—and detail the complex, multi-step process from ER arrival to cath lab intervention. Their institution experienced a drop in performance due to increased patient volume and logistical challenges, prompting a comprehensive team-based quality improvement effort.<br /><br />Key interventions included improved collaboration between ER and cath lab staff, process mapping, real-time STEMI case reviews within 48 hours, and empowering frontline staff to activate STEMI protocols. They addressed challenges such as space constraints, patient flow, and communication. Adoption of pre-hospital EKGs and activation protocols, as well as new technology like secure communication apps, have further shortened times.<br /><br />They stress the importance of trust, shared accountability, conflict management, ongoing training, and leveraging registries for benchmarking and improvement. Emphasizing a systems approach and team dynamics, they advocate continual assessment, emergency medical services engagement, and celebrating successes.<br /><br />Their insights reflect how coordinated multidisciplinary efforts and technological tools enhance patient outcomes in acute cardiac care. Finally, they encourage sharing best practices broadly to elevate STEMI care quality nationwide.

Keywords

Intravascular imaging

Percutaneous coronary intervention

IVUS

OCT

Cardiovascular care

Plaque assessment

Stent placement

Regulatory challenges

Non-invasive imaging

door-to-balloon time

STEMI care

quality improvement

emergency room collaboration

process mapping

pre-hospital EKG

team-based approach

cardiac care outcomes