Implementing “Chest Pain Pathway” Using Smartphone Messaging Application “WhatsApp” as a Corrective Action Plan to Improve Ischemia Time in “ST-Elevation Myocardial Infarction” in Primary PCI Capable Center “WhatsApp-STEMI Trial”

In this study, we aimed to assess the utility of structuring chest pain pathway (CPP) with the instantaneous case-by-case feedback protocol using WhatsApp and its impact on improving 2 major key performance indicators—the impact on initial emergency room (ER) door-to-electrocardiogram (ECG) time, and door-to-balloon time—in a predefined 6-month corrective action period. Methods: A prospective, quality improvement plan was set to reduce door-to-first-ECG and door-to-balloon times to less than 10 and 90 minutes, respectively, in all acute coronary syndrome cases (including STEMI cases), from August 2020 to April 30, 2021. Several measures were done to attain the goal, including strict compliance to CPP with documentation, ruling out possible mimickers, and reducing false activation and time delays in ER. Direct feedback on cases was provided using WhatsApp messaging app on smartphones; protocol and results of time lines were accessed by all healthcare providers associated with CPP, including ER nurses, ER doctors, Cardiology residents, specialists, Catheterization laboratory nurses, technicians, and interventionalists. Bimonthly meetings with all stake holders were reinforced, and minutes of meeting were reviewed and corrective actions were implemented the next day. On a daily basis, all cases were analyzed and tabulated by a dedicated nurse and a doctor from ER, and another nurse and doctor from the quality assurance department. Results: After a 6-month perio...
Source: Critical Pathways in Cardiology - Category: Cardiology Tags: Original Study Source Type: research