Other Heart Attack Measures



Improvement Stories

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

Time to Primary PCI of Less Than or Equal to 90 Minutes

What are we measuring and why?

MGH tracks the percentage of eligible adult heart attack patients with a clogged heart artery who receive a primary percutaneous coronary intervention (also known as PCI balloon therapy) within 90 minutes of arrival at the hospital. PCI opens the clogged artery, which increases blood flow to the heart and reduces heart damage. Delivering this therapy within a brief timeframe has been shown to have a positive impact on outcomes for patients with certain types of heart attacks.

How are we doing and how do we compare to best practice?

This data is no longer collected by the Joint Commission, nor is it publically reported. MGH annual performance on this measure (the percentage of patients getting a PCI in under 90 minutes) has historically tracked with the national average. The national average includes all types of hospitals, not just academic medical centers like MGH. Efforts continue to focus on performance in this area . Our performance for the last reporting period, January 2014 to December 2014 was 97%. The national average for all Joint Commission accredited hospitals was 96%.

Click to see MGH's performance on this measure by patients' race.

  • Current Scores
  • Scores Over Time
  • Higher values are better
96% 100% 97%

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.

N.B. Data for this measure is no longer being collected, nor is it publically reported.

MGH: Jan 14-Dec 14
TJC: Jan 14-Dec 14

96 98 95 95 98 97 99 98 96 96 95 95 96 96 96 96 100 100 100 100 100 100 100 100

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.

N.B. Data for this measure is no longer being collected, nor is it publically reported.



What are we doing to improve?

Our team reviews each case to identify opportunities to improve performance.  We have created a multidisciplinary team that includes representatives from Cardiology, Emergency Medicine, Nursing, and Administration to lead this quality improvement effort. This team has developed several key initiatives that have improved the overall door-to-balloon time for patients with heart attack. Some of these initiatives include immediate ECG (Electrocardiogram) at triage for all patients with chest pain and other symptoms that may represent a heart attack. This ECG is reviewed immediately by an attending emergency physician. If the ECG is diagnostic of STEMI (ST-Segment Elevation Myocardial Infarction), that attending emergency physician is empowered to activate the entire cath team with a single pager notification. If the diagnostic ECG is performed in the field (in the ambulance) and communicated to the ED, the attending emergency physician will activate the entire cath lab prior to the patient’s arrival in the ED.

What can you do?

If you or a family member comes to the hospital with a heart attack, you can help ensure that eligible heart attack patients get quality care by immediately asking the physician whether PCI would be appropriate. Since the timing of PCI really matters, the issue should be raised promptly after a diagnosis of heart attack is confirmed.

 

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