Improvement Stories

“Time is Muscle:” Reducing Door to Balloon Time Can Save Lives of Heart Attack Patients

Why does door-to-balloon matter to high-quality heart attack care?

Every minute counts when a patient suffers a severe heart attack. Indeed, “time is muscle” as for every minute blood flow to the heart is blocked, heart muscle is being deprived of oxygen. A patient’s chances of survival depend on the hospital having well-coordinated and efficient processes to transit patients from the ambulance, through the Emergency Department, and into the Cardiac Catheterization Lab to have the blockage removed. Studies have established a national benchmark called “door-to-balloon” time (DTB), which measures how quickly a patient moves from the Emergency Department to the Catheterization Lab. The current goal for hospital DTB performance is 90 minutes or less.

How did the MGH reduce door to balloon time?

Reducing DTB requires extensive coordination between ambulance, Emergency Department, and Cardiac Catheterization Lab personnel. By establishing standard processes, MGH has made steady progress at moving patients more quickly through each essential step of their care. We have implemented several solutions, one of which involves receiving advanced notification when potential heart attack patients are en route to the hospital.

Where are we now?

Since launching strategies to decrease door-to-balloon time in 2002, the median time has fallen more than 50 percent at MGH. This reduction means more heart attack patients have a better chance at survival.


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