Reducing door to-balloon-time for acute ST elevation myocardial infarction in primary percutaneous intervention:The role of lean six sigma improvement

5^th World Heart and Brain Conference

September 24-26, 2018 Abu Dhabi, UAE

Samer Ellahham

Cleveland Clinic Abu Dhabi, UAE

Keynote: J Cardiovasc Dis Diagn

Abstract :

Cardiovascular diseases are the leading causes of death in the UAE. Prompt reperfusion access is essential for patients who have Myocardial Infarction (MI) with ST-segment elevation as they are at a relatively high risk of death. This risk may be reduced by primary Percutaneous Coronary Intervention (PCI), but only if it is performed in a timely manner. Guidelines recommend that the interval between arrival at the hospital and intracoronary balloon inflation (Door-to- Balloon (D2B) time) during primary PCI should be 90 minutes or less. The earlier therapy is initiated, the better the outcome. Our aim was to decrease the door-to-balloon time for patients with ST Segment Elevation Myocardial Infarction (STEMI) who come through the Emergency Department (ED) in a tertiary hospital in UAE, to meet the standard of less than 90 minutes. A multidisciplinary team was formed including interventional cardiologists, catheterization laboratory personnel, emergency department caregivers and quality staff. The project utilized the Lean Six Sigma Methodology which provided a powerful approach to quality improvement. The process minimized waste and variation and a decreased median door-to-balloon time from 75.9 minutes to 60.1 minutes was noted. The percentage of patients who underwent PCI within 90 minutes increased from 73% to 96%. In conclusion, implementing the Lean Six Sigma methodology resulted in having processes that are leaner, more efficient and minimally variable. While recent publication failed to provide evidence of better outcome, the lessons learned were extrapolated to other primary percutaneous coronary intervention centers in our system. This would have marked impact on patient safety, quality of care and patient experience.

Biography :

Samer Ellahham has served as the Chief Quality Officer for SKMC. He has worked as a Chief Quality Officer and Global Healthcare Leader, focusing on ensuring that that implementation of the best practices lead to breakthrough improvements in clinical quality and patient safety. He is a Certified Professional in Healthcare Quality (CPHQ) by The National Association for Healthcare Quality (NAHQ). He is certified in Medical Quality (CMQ) by The American Board of Medical Quality (ABMQ). He is the recipient of the Quality Leadership Award from the World Quality Congress and Awards and the Business Leadership Excellence Award from World Leadership Congress.

E-mail: samerellahham@yahoo.com