Plainview Hospital Emergency Department, Northwell Health

Plainview, New York

As it prepared to establish a new cardiac cath lab in June 2023, the Plainview Hospital emergency department staff nurses, providers, and leaders collaborated with the hospital’s senior leadership, quality, and onboarding cath lab team to define target metrics. The team turned to evidence-based practice to establish objectives well within national benchmarks for door-to- EKG, EKG-to-STEMI activation, activation-to-table, table-to-balloon/intervention, and door-to-balloon/intervention.

Additionally, Plainview’s ED team provided education and training to EMS departments in its vicinity on the early recognition of myocardial infarction signs and symptoms and the immediate performance of an EKG, which are imperative in preventing acute heart failure or cardiac arrest in the STEMI patient. The door-to-EKG times were 3.5 and 4.1 minutes in the last two quarters of 2023, while the average door-to-balloon time stands at 65 minutes, notably beneath the AHA recommendation of 90 minutes. After every case, a one-page STEMI feedback report is created that includes pre- and post-balloon pictures of the patient’s heart, the initial EKG, and actual times vs. goal times. The report is then shared with the ED team and physician partners to assess additional opportunities for improvement and plan to address barriers or delays that affect patient outcomes.