“Door-to-balloon” time is a phrase commonly used in hospitals to describe the amount of time it takes doctors to perform a procedure called angioplasty on emergency room patients. Within 90 minutes of arrival—that’s the ER goal that cuts the risk of dying by about 40 percent. It’s also a quality-ranking factor for hospitals nationwide.
"We took a look at ourselves and said this is really taking too long," said McGowan Institute faculty member Dr. Joon Sup Lee, clinical director of the Cardiovascular Institute at the University of Pittsburgh Medical Center. "We found that unacceptable."
In the past year, UPMC Presbyterian has cut its door-to-balloon time to 73 minutes from 110 minutes. Among other things, the Oakland hospital has done it by evaluating all potential victims of a heart attack within 5 minutes of their arrival and by allowing ER doctors to make key decisions instead of consulting with cardiologists.
A study published in the November issue of the New England Journal of Medicine explained that angioplasties can be done quickly if several guidelines are followed, including having paramedics perform an electrocardiogram en route to the hospital.
Already several emergency medical service organizations have the EKG machines in their vehicles, and that has greatly contributed to decreasing the door-to-balloon time, Lee said.
"Ideally, if you get an EKG before the patient comes in, you've already pre-identified that patient as someone that needs rapid transit through the system," he said.
Illustration: McGowan Institute for Regenerative Medicine.
Pittsburgh Tribune-Review (07/29/07)
New England Journal of Medicine Abstract (11/09/06)