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National Door-to-Balloon Time Standards and Practices

Goals Accomplishment in the Project

The goal of the program “Reducing door-to-balloon time for acute ST-elevation myocardial infarction in the primary percutaneous intervention” was to develop practical strategies to reduce the door-to-balloon (D2B) time among STEMI patients (Ellahham, Aljabbari, Mananghaya, Raji, & Zubai, 2015). The unique feature of this program was the necessity to investigate the resources available at Kendall Regional Medical Center to support the promotion of care for patients in need and to develop a specific approach to motivate and educate employees about this pressing issue.

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At the same time, it was essential to investigate the national standards of D2B time for STEMI patients, compare the resources of Kendall Regional Medical Center to reduce this time, and develop a needs assessment tool to determine stakeholders and possible improvements (Coyne et al., 2015). All these goals were accomplished in the project. A thorough investigation, use of available databases, and communication with different stakeholders were the primary means used to answer the project’s main research questions and support improvements in D2B time for STEMI patients.

Nature of Personal Experience

Taking into consideration the goals of the project and the methods used during the investigation, it is possible to say that the project involved a positive experience in the given hospital setting. First of all, the researcher could use different databases and rely on investigations made by experts in the chosen spheres. Secondly, it was necessary to promote the development of communicative skills and knowledge to gather relevant opinions and additional information for the project. Indeed, communication with hospital staff is always required for appropriate diagnosis and treatment (Thylen, Ericsson, Angerud, Isaksson, & Lawesson, 2015). Many stakeholders and other crucial contributors to the project people were involved.

It was also interesting to make observations and analyze the results to answer the project’s main research questions. In particular, the measurement of the needs assessments made a significant contribution to the project (LaVela & Gallan, 2014). Finally, the experience was positive because of the strong possibility of a reduction in D2B time.

Beneficial Resources in the Project

Even though certain positive experiences were had by the researcher and that the goals of the project were largely achieved, there are still many other methods and approaches that would improve the project and bring additional benefits. For example, it would be helpful to pay more attention to recent investigations and achievements. There is no need to establish publication measurements but rather to focus on projects developed during the last year only. There were many publications in 2016. Recent investigations by Al Bugami et al. (2016) proved the success of PCI as the primary treatment strategy for STEMI patients. Therefore, paying more attention to recent research could be beneficial for the project. Another relevant research study was developed by Kaufman, Christianson, Keshishian, Mitra, and Berlowitz (2016), who believed that a reduction in D2B time was not connected with any improvement in myocardial salvage or a reduction in the mortality rate. Therefore, it is necessary to investigate what other medical outcomes could be effective in reducing D2B time.

In addition to the recognition of up-to-date sources, it is also possible to use resources like the thoughts of medical workers who are directly involved in the process when STEMI patients are transported to the hospital, as well as the opinions of patients and their families about the quality of care offered and their real expectations. A comparison of these results should open some new perspectives regarding STEMI patient experience and treatment.

Importance of a Navigator in the Project

In some cases, projects similar to the one under analysis were improved using a special navigator. Navigators help researchers make correct choices and follow prescribed standards. However, despite all the benefits, it is not always reasonable to utilize a navigator. The task for the participants of such a project is to find new ways and methods of reducing the D2B time among STEMI patients. If only the same measurements and requirements are followed, it will be hard to achieve something new. It is thus necessary to promote innovations and rely on human factors in health care.

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Al Bugami, S., Alrahimi, J., Almalki, A., Alamger, F., Krimly, A., & Al Kashkari, W. (2016). ST-segment elevation myocardial infarction: Door to balloon time improvement project. Cardiology Research, 7(4), 152-156.

Coyne, C. J., Testa, N., Desai, S., Lagrone, J., Chang, R., Zheng, L., & Kim, H. (2015). Improving door-to-balloon time by decreasing door-to-ECG time for walk-in STEMI patients. Western Journal of Emergency Medicine, 16(1), 184.

Ellahham, S., Aljabbari, S., Mananghaya, H., Raji, J., & Zubai, A. (2015). Reducing door-to-balloon time for acute ST-elevation myocardial infarction in the primary percutaneous intervention: Transformation using robust performance improvement. BMJ Quality Improvement Reports, 8(4), 1-4.

Kaufman, M. V., Christianson, L., Keshishian, E., Mitra, A., & Berlowitz, M. (2016). Significant decreases in door to balloon times do not correlate with meaningful reduction in mortality or improved myocardial salvage in a single center retrospective study. Journal of the American College of Cardiology, 67(13), 645.

LaVela, S. L., & Gallan, A. S. (2014). Evaluation and measurement of patients experience. Patients Experience Journal, 1(1), 28-36.

Thylen, I., Ericsson, M., Angerud, K. H., Isaksson, R.-M., & Lawesson, S. S. (2015). First medical contact in patients with STEMI and its impact on time to diagnosis: An explorative cross-sectional study. BMJ Open, 5(4). Web.

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