John Porter, Erin M Larson, Courtney E Bennett, Chad P Liedl, Jason T Churchill, Kathy S Berns, Brent A Konz, Sue C Eastman, Lisa C Rentz, Michael B Juntunen, Matthew P Johnson, Dennis A Laudon
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Improving Efficiencies in STEMI Care via the DMAIC Framework: Report of a Successful Quality Improvement Project.
Background: Timely recognition, diagnosis, and treatment of ST-segment elevation myocardial infarctions (STEMIs) are critical for patient survival.
Local problem: Our door-to-balloon (D2B) times, a key quality metric, were increasing.
Methods: The DMAIC (Define, Measure, Analyze, Improve, Control) framework was used for this quality improvement project to determine gaps in care and to improve efficiency.
Interventions: We streamlined STEMI patient care models, eliminating unnecessary steps, codifying throughput pathways, and improving interdepartmental communication.
Results: Median D2B times decreased from 62.5 to 57 minutes in patients initially seen at the acute care facility and from 116 to 114 minutes in patients who transferred to our facility. We observed no increase in the number of patients arriving at the cardiac catheterization laboratory before the room or team were ready.
Conclusions: A nurse-led quality improvement project that includes nurses directly involved in the care of patients can achieve real improvements in quality of care.
期刊介绍：
Journal of Nursing Care Quality (JNCQ) is a peer-reviewed journal that provides practicing nurses as well as nurses who have leadership roles in nursing care quality programs with useful information regarding the application of quality principles and concepts in the practice setting. The journal offers a forum for the scholarly discussion of “real world” implementation of quality activities.
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