Quality Improvement in Health Care (한국의료질향상학회지)

Korean Society for Quality in Health Care (한국의료질향상학회)
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Effect of emergency bell on door to ECG time in walk-in patients presented to emergency department with chest pain

흉통을 주소로 응급실에 내원한 환자에서 심전도 촬영 소요 시간에 대한 응급벨 제도의 효과

  • Kim, Min-Woo (Department of Emergency Medicine, College of Medicine, The Catholic University of Korea) ;
  • Oh, Sang-Hoon (Department of Emergency Medicine, College of Medicine, The Catholic University of Korea) ;
  • Park, Kyu-Nam (Department of Emergency Medicine, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jung-Min (Department of Emergency Team, Emergency Medical Center, Seoul St. Mary Hospital) ;
  • Lee, Young-Mee (Department of Emergency Team, Emergency Medical Center, Seoul St. Mary Hospital) ;
  • Kim, Han-Joon (Department of Emergency Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Soo-Hyun (Department of Emergency Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kang, Dong-Jae (Department of Emergency Medicine, College of Medicine, The Catholic University of Korea)
  • 김민우 (가톨릭대학교 의과대학 응급의학교실) ;
  • 오상훈 (가톨릭대학교 의과대학 응급의학교실) ;
  • 박규남 (가톨릭대학교 의과대학 응급의학교실) ;
  • 이정민 (서울성모병원 응급의학과) ;
  • 이영미 (서울성모병원 응급의학과) ;
  • 김한준 (가톨릭대학교 의과대학 응급의학교실) ;
  • 김수현 (가톨릭대학교 의과대학 응급의학교실) ;
  • 강동재 (가톨릭대학교 의과대학 응급의학교실)
  • Received : 2014.04.27
  • Accepted : 2014.07.10
  • Published : 2014.07.11
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Abstract

Objectives: The aim of this study was to explore whether emergency bell could shorten door to electrocardiograms (ECG) time in chest pain patients presenting to emergency department (ED) by self-transport. Methods: This was a planned 6-month before-and-after interventional study design. We set up the emergency bell in walk-in patients' waiting room. Prior to the change, patients were triaged before an ECG was obtained. In new process, as soon as patient with chest pain push the emergency bell, emergency physicians examined patient and prioritized performing ECG. We analyzed door to electrocardiograms (DTE) times for patients with chest pain and ST segment elevation myocardial infarction (STEMI) patients between two periods. Results: During the enrollment period, a total of 63 patients called emergency bell. The median DTE time was 6 min (interquartile range: 3.0 - 9.0) and 82.5% received an ECG within 10 minutes, and only three patients were STEMI. DTE time in patient with chest pain was not different between two periods (p=0.980). Before intervention period, 15 walk-in patients admitted in ED for STEMI and 53.8% of STEMI patients received an ECG within 10 minutes. After intervention period, total 19 walk-in patients admitted in ED for STEMI. Of these, 89.5% met the time requirement. Conclusion: Because a small portion of patients with chest pain activated the emergency bell, new strategy for promotion of emergency bell must be needed.

Keywords

References

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