Reducing Door-to-Balloon Time

McLeod Regional Medical Center

Synopsis of Work: Pursuing Perfection: Raising the Bar for Health Care Performance—a national program of the Robert Wood Johnson Foundation (RWJF)—supported efforts by seven health care organizations to dramatically improve their care processes and patient outcomes. McLeod Regional Medical Center of Florence, S.C., worked to speed up heart attack treatment, to reduce the time lapse from when the victim enters the emergency room to when the blocked artery is opened—commonly called the door-to-balloon time because of the catheter balloon and stent typically used in the unblocking procedure.

The work taught the staff to set a goal, break down the relevant processes minute-by-minute, identify improvement opportunities and measure the results-lessons that could be applied to other areas of care.

Story Told: As a key part of its project to improve heart attack care, McLeod set a door-to-balloon goal of 90 minutes for every patient—a half-hour faster than the national guideline and far better than the hospital had been averaging up to that point.

Meeting the goal required more than simply working faster; it required changes in the hospital's ER triage process, its method for alerting the catheterization lab team and the way its emergency medical technicians and cardiologists worked with each other.

Because of its efforts, McLeod cut its heart attack mortality rate in half.

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