Cleveland Clinic Main Campus Emergency Department

Cleveland, Ohio

The Cleveland Clinic Main Campus Emergency Department sustained an average door-to-balloon time of 50 minutes in 2024 and 2025, sitting well below the 90-minute benchmark recommended by the American College of Cardiology and the American Heart Association. This performance reflects a highly coordinated, team-based approach to STEMI care where urgency, preparation and reliability are embedded in the workflow. The average ED-in to ED-out times over the last eight quarters was 19 minutes. Notably, the fastest ED-in to ED-out time was 4 minutes, which demonstrated an ability to mobilize rapidly when every second counts. A key driver of this success is the EMS STEMI bypass collaboration.

Through standardized stroke alert workflows, interdisciplinary collaboration and ongoing performance monitoring, the 86-bed department also maintains exceptional stroke care. Key initiatives include an active ED Stroke Champions program, regular stroke case reviews and real-time feedback mechanisms that engage front-line nurses, providers and ancillary staff. Stroke Champions serve as on-shift resources who provide peer support, reinforce best practices and promote situational awareness during time-sensitive stroke evaluations. These processes provide formal mechanisms to take periodic snapshots of care delivery, identify opportunities for improvement and aim to sustain consistent performance despite fluctuations in patient volume and acuity.