Effect of Team Resource Management on Quality of Care in Patients with Acute ST-elevation Myocardial Infarction
Date Issued
2015
Date
2015
Author(s)
Wu, Xue-Ming
Abstract
Background and Objectives: The ST-segment elevation myocardial infarction (STEMI) patients need rapid primary percutaneous coronary intervention (PCI) to get good outcomes. The aim of this study is to assess the effect of implementing team resource management (TRM) in managing STEMI patients in Taoyuan General Hospital. Methods: This study includes STEMI patients, who underwent primary PCI in Taoyuan General Hospital. These patients are divided into two study groups: one group consists of 109 STEMI patients, who were admitted to our hospital during the pre-TRM period (from January, 2009 to December, 2010) and the other group consists of 97 STEMI patients, who were admitted to our hospital during the post-TPM period (from February, 2011 to January, 2013). We analyze the DTB times and clinical outcomes of both groups. Results: The mean DTB time of post-TRM group is significantly shorter than that of the pre-TRM group (82.6±14.5 vs 107±27 min; p<0.001). Four intervals of DTB time (door to ECG, ECG to CV doctor, CV doctor to PCI team, and ER to cath room) are all significantly shorter after the implementation of TRM. The clinical outcomes (days of ICU stay, total admission days, and major adverse cardiac events) are not different between these two groups. However, patients with longer DTB time (> 90 min) have higher MACE rate. Conclusion: Implementation of TRM at our institution significantly reduces DTB times of STEMI patients. However, the clinical outcomes are not improved by TRM.
Subjects
door to balloon time
team resource management
quality improvement
acute myocardial infarction
primary percutaneous coronary intervention
Type
thesis
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