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KMID : 1031020140200010012
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Quality Improvement in Health Care
2014 Volume.20 No. 1 p.12 ~ p.24
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Effect of emergency bell on door to ECG time in walk-in patients presented to emergency department with chest pain
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Kim Min-Woo
Oh Sang-Hoon
Park Kyu-Nam
Lee Jung-Min
Lee Young-Mee
Kim Han-Joon
Kim Soo-Hyun
Kang Dong-Jae
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Abstract
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Objectives: The aim of this study was to explore whether emergency bell could shorten door to electrocardiograms (ECG) time in chest pain patients presenting to emergency department (ED) by self-transport.
Methods: This was a planned 6-month before-and-after interventional study design. We set up the emergency bell in walk-in patients’ waiting room. Prior to the change, patients were triaged before an ECG was obtained. In new process, as soon as patient with chest pain push the emergency bell, emergency physicians examined patient and prioritized performing ECG. We analyzed door to electrocardiograms (DTE) times for patients with chest pain and ST segment elevation myocardial infarction (STEMI) patients between two periods.
Results: During the enrollment period, a total of 63 patients called emergency bell. The median DTE time was 6 min (interquartile range: 3.0 - 9.0) and 82.5% received an ECG within 10 minutes, and only three patients were STEMI. DTE time in patient with chest pain was not different between two periods (p=0.980). Before intervention period, 15 walk-in patients admitted in ED for STEMI and 53.8% of STEMI patients received an ECG within 10 minutes. After intervention period, total 19 walk-in patients admitted in ED for STEMI. Of these, 89.5% met the time requirement.
Conclusion: Because a small portion of patients with chest pain activated the emergency bell, new strategy for promotion of emergency bell must be needed.
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KEYWORD
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Electrocardiography, Chest pain, Reperfusion
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