ACC Releases List of Hospitals Participating in “D2B: An Alliance For Quality”

Program experiences rapid growth since November 2006 launch
The American College of Cardiology (ACC) released the list of hospitals that have joined “Door-to-Balloon: An Alliance for Quality” since the program launch in November 2006. To date, 833 hospitals have registered for the D2B program; the list of participating hospitals can be found at http://www.d2balliance.org/ParticipatingHospitals/tabid/159/Default.aspx. “D2B: An Alliance for Quality” is a Guidelines Applied in Practice (GAP) program developed by the ACC and a host of partner organizations to save time and lives by reducing the door-to-balloon times in U.S. hospitals performing primary percutaneous coronary intervention (PCI), or angioplasty with stenting.

“This initiative has had an outstanding reception and hospitals are seizing the opportunity to save time and save lives. I am inspired by the enthusiasm across the country by hospitals that are promising timely care to their patients and making sure they deliver on that promise,” said Harlan Krumholz, MD, FACC, chair of the D2B Working Group. “Times that were once thought to be impossible are becoming commonplace at many institutions — and what was once best practice is becoming typical practice. This effort, through the dedicated work of the clinicians, health care professionals, hospitals and organizations, will make a big difference to individual patients and their families.”

Previous guidelines developed by the ACC and the American Heart Association (AHA) recommended that hospitals treating ST-elevation myocardial infarction (STEMI) patients with PCI should reliably achieve a door-to-balloon time of less than 90 minutes; however, hospitals struggled to meet recommended times. The D2B initiative identified opportunities to improve the quality of patient care and help hospitals reduce their door-to-balloon times.

Several evidence-based strategies were identified to assist hospitals in reducing their door-to-balloon times. The strategies involve multiple departments and require a systems approach. They include:

  • The emergency medicine physicians activate the catheterization laboratory (cath lab)
  • A single call activates the cath lab
  • The cath lab team arrives and is ready within 20-30 minutes
  • Real-time data feedback in the emergency department and the cath lab
  • Senior management commitment

Participating hospitals received an implementation manual and tool kit, as well as information on how to best construct the team needed to implement the changes; what the roles and responsibilities of each member should be; and how to identify the point person for the project within each primary PCI hospital.