Some principles never change. In particular, the well-known 2006 Circulation study, "Achieving Rapid Door-to-Balloon Times," presents findings and take-aways that are still incredibly ED-Doc-Nurses-patient-x600-900772-edited.jpgrelevant for STEMI teams today. The aim of the study was to examine the similarities between the STEMI centers that had successfully improved their D2B times over a 3-year period, citing that fewer than half of all STEMI patients receive proper treatment within the guideline-recommended D2B times.
While this is an older article, the lessons for developing strong time sensitive emergency teams are still very relevant. The study identified several themes that were common among the most successful hospitals, which I will expand upon with an eye toward care in the current age, as well as suggest ways that Pulsara can assist with each aim. However, it is crucial to understand that there is no magic bullet - not even Pulsara. Providing the best care is a goal that is dependent on and can only be achieved by the people working in your hospital's care teams. This goal is a constant work in progress, and we are never done improving.  That's why at Pulsara, our purpose is to improve the lives of patients and caregivers through innovative communication. 

THEME 1: Set Explicit Goals (like Door to Balloon or Door to Needle)

This is critical to motivating and sustaining improvement efforts. And more than just a one-off team building activity, goal setting MUST BE PART OF THE CULTURE if it's truly going to succeed. Once you have your goals in place, external reporting is key to maintaining interest and focus on the targets. Need more help? Pulsara's Universal Clock and built-in workflows make your teams' goals known and meaningful during an active case. 

THEME 2: Visible Senior Management Support

Senior management has the power to make things happen that individual clinicians may struggle to. This power includes things that are crucial to innovation and improvement such as mobilizing resources, managing resistance to change, holding people and teams accountable, and promoting messaging and sharing of performance data. 

  • Pulsara provides easy-to-consume data and tools to help your senior management operationalize change.

THEME 3: Implement Standardized Protocols AND Maintain Flexibility to Continually Revisit and Improve Protocols.

In order to improve your protocols, everyone must be on the same page. Your team needs to break down your current protocols and continue to refine them, knowing that all protocols have their weaknesses. The only way to make sure those weaknesses don't seep into your quality of care is to continuously measure, evaluate, and improve your protocols.

  • The data Pulsara collects about your case times and protocols provides accountability and transparency to help you pinpoint where improvements are needed. 

THEME 4: Uncompromising Individual Clinical Leaders

Successful programs have one or more strong clinical leaders who are committed, tenacious, and uncompromising in their efforts to achieve their system’s stated goals. 

  • Pulsara provides a focal point to center the your team's conversations around.

THEME 5: Collaborative, Interdisciplinary Teams

Nobody can care for a patient all the way through to definitive treatment by themselves.  It requires a team working together and trusting each other.

  • Pulsara unites and empowers ALL team members, making your entire team available with a just tap. AND, everyone gets immediate feedback to see how well they performed.

THEME 6: Data Feedback to Monitor Progress and Identify Problems or Successes

Rapid, patient-specific data feedback is critical to improvement.  You can identify where delays are occurring, motivate changes, reinforce adherence to protocols, make visible the teams’ successes, and sustain new processes over the longer term.

  • With Pulsara, it does NOT have to be labor intensive and can be delivered in real time and made meaningful during an active case.

THEME 7: Organizational Culture That Fosters Persistence Despite Challenges and Setbacks

There will be challenges.  A non-blaming approach to identifying system problems and a shared vision of improving the patient’s health is key. 

  • Pulsara uncovers where the team is struggling and motivates all team members to focus on and provide patient-centric care. 
James Woodson, MD

Written by James Woodson, MD

James is a board certified Emergency Physician, and is the Founder, CEO, and President of Pulsara.