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Overcoming the Hurdles Improving DTB in the
LVHHN MI-Alert Program
Richard S. MacKenzie, MD, FACEPChairDepartment
of Emergency MedicineLehigh Valley Hospital
Health Network
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Problem at the Millenium

• Inconsistency
• Mortality 5-7 PCI
• Mortality lytic 6-16

EUR HEART J. 2002 23 550
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(No Transcript)
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PSIMT

• Plan
• Problem identification clarification
• Solution identification clarification
• Presentation for input
• Do
• Implement - education precedes date
• Presentation for understanding

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PSIMT (2)

• Study - Monitor for
• protocol violations
• anecdotes
• Trends
• Act Tweak the process

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D2B Specifics Road Show

• Remove decisions
• streamline by consistency no artists
• Reduce transitions or hand-offs
• Challenge tradition
• Dance the same dance
• Order Sheets

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Regional MI AlertThe Core

• STEMI only
• Definitive State-of-the-Art care
• One call does it all
• Parallel vs. sequential processing
• Tight reporting of data for performance
  improvement

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Faster is better
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Reduction in Mortality!

• Overall Mortality
• STEMI local and regional 2.4