St. Francis Hospital and Heart Center Emergency Department

Roslyn, New York

St. Francis Hospital and Heart Center’s emergency department strives for continuous improvement in the care and outcomes of patients experiencing chest pain and acute coronary syndrome symptoms. The ED clinical nurses work collaboratively with the cardiac cath lab nurses and currently monitor arrival to EKG completed within 10 minutes with a goal of at least 80 percent, which aligns with the American College of Cardiology, along with door to balloon times. The ED clinical nurses identified opportunities to improve troponin turnaround times in the ED. The nurses used the Plan Do Study Act performance improvement model to develop and implement changes. The ED nurses collaborated with the laboratory, IT and others to collect baseline data. The median time from arrival to troponin result in 2022 was 124 minutes. In June 2024 it had dropped to 39 minutes. The orders are placed by the triage advanced patient provider, and blood is drawn in triage after the EKG. The ED nurses, with the help of IT providing spread sheets, reviewed the turnaround times and discussed progress at unit based council, huddles and staff meetings. While the process is still new, data are trending in the right direction.