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Reducing Time Delay in the Thrombolysis of Myocardial Infarction: An Internal Quality Improvement ProjectSchool of Medicine, University of Murcia, Spain, psaturno{at}fcu.um.es
Intensive Care Unit, University General Hospital, Murcia, Spain
Intensive Care Unit, University General Hospital, Murcia, Spain
Intensive Care Unit, Hospital Carlos Haya, Mdlaga, Spain
Intensive Care Unit, Hospital Carlos Haya, Malaga, Spain ARIAM Project Group The objectives of this study were to improve thrombolytic therapy in acute myocardial infarction by reducing the "door-to-needle" time in a 285-bed university hospital in Spain. A quality management approach was used involving all the relevant staff. Target standard was set at 35 minutes. Baseline data, intervention effect, and continuous monitoring were analyzed using x control charts. Analysis of baseline data showed a wide out-of-control variation and 72 minutes' average delay. Cause analysis revealed organizational and clinical problems that were subjected to intervention. Postintervention data showed a stable process, with an average of 30 minutes. Continuous monitoring showed further improvement in average time and predictable variation. The template of the current control chart has an average of 26 minutes. Quality management methods, particularly staff involvement in problem analysis and intervention design, and the use of control charts were useful to understand, solve, and continuously monitor an important clinical problem whose existence was evident only after it was measured.
Key Words: Acute myocardial infarction • in-hospital delay • statistical process control • thrombolysis
American Journal of Medical Quality, Vol. 15, No. 3,
85-93 (2000) This article has been cited by other articles:
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