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  1. The "Door-to-Needle Blitz" in acute myocardial infarction : the impact of CQI project.

    Article - En anglais


    A continuous quality improvement (CQI) project was conducted at Soroka Medical Center in Beer-Sheva, Israel, in an effort to identify and address causes of delays in thrombolytic therapy in patients arriving at a high-volume (160,000 patients per year) emergency department with acute myocardial infarction and thereby reduce the « door-to needle time » (DTNT).

    The study had four phases 

    Preintervention survey, peri-intervention process redesign, postintervention evaluation, and follow-up evaluation.

    CQI team : The CQI team followed a seven-step protocol : problem definition, present-state screening, factors analysis, solution development, outcome evaluation, standardization, and conclusions.


    A DTNT of 45 minutes was considered acceptable for this data set, and accordingly, patients were divided into an « early » group (n=50, DTNT<45 minutes), and a « late » group (n=50, DTNT>=45 minutes).

    After the CQI intervention, the mean DTNT decreased from 61.8+/-32.5 (mean+/-standard deviation) to 47.6+/-18.5 minutes (p<0.0029).

    The prolonged DTNT time intervals of the late versus the early groups was primarily due to extended decision-making time (36.0+/-22.7 versus 13.6+/6.7 minutes, p<0.003), followed by time until therapy was initiated (26.2+/-14.2 versus 11.1+/-5.8 minutes, p<0.002). (...)

    Mots-clés Pascal : Infarctus, Cardiopathie coronaire, Cardiopathie, Appareil circulatoire pathologie, Maladie, Soin, Israël, Moyen Orient, Asie, Monde, Milieu hospitalier, Urgence, Service hospitalier, Organisation hospitalière, Qualité, Aspect politique, Géographie

    Mots-clés Pascal anglais : Infarct, Coronary heart disease, Heart disease, Cardiovascular disease, Disease, Care, Israel, Middle east, Asia, World, Hospital environment, Emergency, Hospital ward, Hospital organization, Quality, Political aspect, Geography

    Logo du centre Notice produite par :
    Observatoire Régional de la Santé Auvergne-Rhône-Alpes

    Code Inist : 002B30A11. Création : 11/09/1998.