William Gibson, Dawoud Al Kindi, François Brouillette, Ahmed Aldajani, Omar Chaabo, Yasmine Lachance, Elie Akl, Kshitij Badal Dandona, Giuseppe Martucci, Jean-Philippe Pelletier, Nicolo Piazza, Jeremy Levett, Tomer Moran, Marco Spaziano
{"title":"基于云的护理协调平台对心导管实验室虚假激活和不必要的团队动员的影响：一项回顾性队列研究。","authors":"William Gibson, Dawoud Al Kindi, François Brouillette, Ahmed Aldajani, Omar Chaabo, Yasmine Lachance, Elie Akl, Kshitij Badal Dandona, Giuseppe Martucci, Jean-Philippe Pelletier, Nicolo Piazza, Jeremy Levett, Tomer Moran, Marco Spaziano","doi":"10.2196/76932","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Rapid activation of the cardiac catheterization laboratory (CCL) for ST-segment elevation myocardial infarction (STEMI) is essential to minimize time to reperfusion. However, system-wide efforts to reduce treatment delays have been accompanied by increased false activations (FA), defined as activations that do not result in emergent coronary intervention. False activations contribute to unnecessary team mobilization (UTM), staff fatigue, workflow disruption, and inefficient resource utilization.</p><p><strong>Objective: </strong>To evaluate whether implementation of a cloud-based care coordination platform (Stenoa) was associated with reductions in FA and UTM at a high-volume tertiary cardiac center.</p><p><strong>Methods: </strong>In September 2021, the McGill University Health Centre (MUHC) implemented Stenoa, a mobile cloud-based STEMI coordination platform enabling systematic case validation using electrocardiographic and clinical data. A retrospective cohort study was conducted including all CCL activations between September 2020 and December 2022. Activations were grouped as pre-implementation (Group 0: Sept 2020-Sept 2021) and post-implementation (Group 1: Sept 2021-Dec 2022). False activation was defined as CCL activation followed by case cancellation before any procedure was performed. The primary outcome was the rate of UTM.</p><p><strong>Results: </strong>A total of 632 activations were analyzed (overall: Group 0: n =288, Group 1: n =344; off- hours activations: Group 0: n =265, Group 1: n =316.) UTM decreased from 8.7% (23/265) to 4.4% (14/316) following platform implementation (P = .04). FA frequency decreased from 10.2% (27/265) to 7.0% (22/316), although this did not reach statistical significance (P = .16). Among false activations, the proportion resulting in UTM declined from 85% to 64% (P =.08).</p><p><strong>Conclusions: </strong>Implementation of a cloud-based STEMI coordination platform was associated with a significant reduction in unnecessary catheterization laboratory team mobilization. Structured digital communication may improve workflow efficiency and resource utilization in STEMI systems of care. Further multicenter evaluation is warranted.</p><p><strong>Clinicaltrial: </strong></p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of a Cloud-Based Care Coordination Platform on False Activations of the Cardiac Catheterization Laboratory and Unnecessary Team Mobilization: A Retrospective Cohort Study.\",\"authors\":\"William Gibson, Dawoud Al Kindi, François Brouillette, Ahmed Aldajani, Omar Chaabo, Yasmine Lachance, Elie Akl, Kshitij Badal Dandona, Giuseppe Martucci, Jean-Philippe Pelletier, Nicolo Piazza, Jeremy Levett, Tomer Moran, Marco Spaziano\",\"doi\":\"10.2196/76932\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Rapid activation of the cardiac catheterization laboratory (CCL) for ST-segment elevation myocardial infarction (STEMI) is essential to minimize time to reperfusion. However, system-wide efforts to reduce treatment delays have been accompanied by increased false activations (FA), defined as activations that do not result in emergent coronary intervention. False activations contribute to unnecessary team mobilization (UTM), staff fatigue, workflow disruption, and inefficient resource utilization.</p><p><strong>Objective: </strong>To evaluate whether implementation of a cloud-based care coordination platform (Stenoa) was associated with reductions in FA and UTM at a high-volume tertiary cardiac center.</p><p><strong>Methods: </strong>In September 2021, the McGill University Health Centre (MUHC) implemented Stenoa, a mobile cloud-based STEMI coordination platform enabling systematic case validation using electrocardiographic and clinical data. A retrospective cohort study was conducted including all CCL activations between September 2020 and December 2022. Activations were grouped as pre-implementation (Group 0: Sept 2020-Sept 2021) and post-implementation (Group 1: Sept 2021-Dec 2022). False activation was defined as CCL activation followed by case cancellation before any procedure was performed. The primary outcome was the rate of UTM.</p><p><strong>Results: </strong>A total of 632 activations were analyzed (overall: Group 0: n =288, Group 1: n =344; off- hours activations: Group 0: n =265, Group 1: n =316.) UTM decreased from 8.7% (23/265) to 4.4% (14/316) following platform implementation (P = .04). FA frequency decreased from 10.2% (27/265) to 7.0% (22/316), although this did not reach statistical significance (P = .16). Among false activations, the proportion resulting in UTM declined from 85% to 64% (P =.08).</p><p><strong>Conclusions: </strong>Implementation of a cloud-based STEMI coordination platform was associated with a significant reduction in unnecessary catheterization laboratory team mobilization. Structured digital communication may improve workflow efficiency and resource utilization in STEMI systems of care. Further multicenter evaluation is warranted.</p><p><strong>Clinicaltrial: </strong></p>\",\"PeriodicalId\":14706,\"journal\":{\"name\":\"JMIR Cardio\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2026-04-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JMIR Cardio\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2196/76932\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR Cardio","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2196/76932","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Impact of a Cloud-Based Care Coordination Platform on False Activations of the Cardiac Catheterization Laboratory and Unnecessary Team Mobilization: A Retrospective Cohort Study.
Background: Rapid activation of the cardiac catheterization laboratory (CCL) for ST-segment elevation myocardial infarction (STEMI) is essential to minimize time to reperfusion. However, system-wide efforts to reduce treatment delays have been accompanied by increased false activations (FA), defined as activations that do not result in emergent coronary intervention. False activations contribute to unnecessary team mobilization (UTM), staff fatigue, workflow disruption, and inefficient resource utilization.
Objective: To evaluate whether implementation of a cloud-based care coordination platform (Stenoa) was associated with reductions in FA and UTM at a high-volume tertiary cardiac center.
Methods: In September 2021, the McGill University Health Centre (MUHC) implemented Stenoa, a mobile cloud-based STEMI coordination platform enabling systematic case validation using electrocardiographic and clinical data. A retrospective cohort study was conducted including all CCL activations between September 2020 and December 2022. Activations were grouped as pre-implementation (Group 0: Sept 2020-Sept 2021) and post-implementation (Group 1: Sept 2021-Dec 2022). False activation was defined as CCL activation followed by case cancellation before any procedure was performed. The primary outcome was the rate of UTM.
Results: A total of 632 activations were analyzed (overall: Group 0: n =288, Group 1: n =344; off- hours activations: Group 0: n =265, Group 1: n =316.) UTM decreased from 8.7% (23/265) to 4.4% (14/316) following platform implementation (P = .04). FA frequency decreased from 10.2% (27/265) to 7.0% (22/316), although this did not reach statistical significance (P = .16). Among false activations, the proportion resulting in UTM declined from 85% to 64% (P =.08).
Conclusions: Implementation of a cloud-based STEMI coordination platform was associated with a significant reduction in unnecessary catheterization laboratory team mobilization. Structured digital communication may improve workflow efficiency and resource utilization in STEMI systems of care. Further multicenter evaluation is warranted.
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