Abuhejleh, A., Dulaimi, M., & Ellahham, S. (2015). Using Lean management to leverage innovation in healthcare projects: case study of a public hospital in the UAE. BMJ Innovations, 2, 22-32. Web.
The article showed that effective implementation of Lean Six Sigma management strategy resulted in vital implications for hospitals. It was noted that the use of Lean management led to notable and sustainable decline in patient access and waiting time. The practice was also associated with enhanced safety and patient satisfaction.
Care delivery, communication, data collection, and cardiac catheterization teamwork were tracked after the implementation of the Lean strategy. The approach was generally based on existing literature on the best methods to decrease D2B. Further modifications to the practice were based on measurement, improvement, and control processes done during the use of the model. The model applied ensured that researchers could identify factors responsible for delays in the door-to-balloon time. It was noted that the Lean Six Sigma model was responsible for significant improvement in D2B. In fact, the number of patients that met the 90 minutes benchmark increased to 98% from 58%. Interdepartmental communication and prompt feedback were also determined. Overall, the model of the Lean Six Sigma led to leaner, efficient processes.
Gokhroo, R. K., Ranwa, B. L., Kishor, K., Priti, K., Ananthraj, A., Gupta, S., & Bisht, D. (2016). Sweating: A Specific Predictor of ST-Segment Elevation Myocardial Infarction Among the Symptoms of Acute Coronary Syndrome: Sweating In Myocardial Infarction (SWIMI) Study Group. Clinical Cardiology, 39(2), 90–95. Web.
This article was based on the concept of ‘time is muscle’ and the ‘golden hour theory’. It has been observed that contemporary cardiologists are focusing on minimizing time between the initial medical contact and device/needle time during this period of intervention to enhance favorable outcomes. Time is muscle concept requires patients to present within a specific period for its effective implementation for possible myocardium. Thus, the golden hour of reperfusion is considered vital relative to event identification by patients and care providers. These concepts are applied to identify ‘red flag’ and enhance awareness of the community and clinical acumen of care providers. Consequently, they improve event-to-reperfusion time. Patients who are most likely to present late usually have dead reperfused myocardium. These concepts were developed to boost time for treatment once the care providers have identified or suspected STEMI at the right time. Hence, they promote a focus on event-to-reperfusion time instead of time to treatment specifically to address unfulfilled health needs.
Shoun, R. (2011). Continuous Quality Improvement of Door-to-Balloon Time at a PCI- Capable Hospital. Cath Lab Digest, 19(7). Web.
The theory JM Juran was used to develop Quality Improvement goals based on procedures and policy designed to enhance door-to-balloon times and eventually improve patient outcomes. Juran’s theory accounted for quality planning, quality control, and quality improvement. Hospitals have used D2B time as a quality measure. In this case, the author showed how teamwork between multiple multidisciplinary professionals could result in better outcomes.
Continuous quality improvement is effective for STEMI patients because it promotes process evolution, development and consistency. These processes are normally refined and redefined to improve care standards. Quality control goals are initiated to reduce door-to-balloon time to less than 90 minutes. Hospitals currently focus on reducing the time to 60 minutes.