2 min read

Research Shows: System Delays are Increasing Mortality Rates at Your Facility


I hear it all the time … “We already have a great system.” or “Our processes are already streamlined.”

stop system delays stroke

While that’s good and dandy, there is a problem that lies in the statement itself. 

“We already have a great system” … compared to what?

“Our processes are already streamlined” … compared to what?  

Quantifiable data would answer this question. Ironically, these types of statements are more consistently heard from suburban and rural facilities. And, while these facilities are honestly working towards a positive outcome, it’s difficult to track progress. It’s time consuming to gather data, review processes, and report the difficult truth.

Maybe it’s the paramedic who didn’t recognize the STEMI. Maybe it’s the cardiologist who’s consistently slow to respond. Maybe it’s the wrong call list or and antiquated phone tree.


My wish? That acute care teams (Stroke Team, Cardiac Team, Trauma Team, etc.) would look at their processes with the same scrutiny as a professional athlete does.

The NASCAR team dissects every minutia of their process … from the driver to communications to changing tires to fueling the car. In fact, it’s so dialed in, many EMS agencies are adopting the Pit Crew CPR mantra.

The same analogy holds true for the hurdler, ski racer and precision pilot. Every second counts. Every decision counts.

Unfortunately, we’re still not there in emergency medicine. While we’ve made great strides, we are still using outdated equipment, old traditions, and “best practices” of yesterday.

What about having a universal clock? What about holding every player on the team accountable for their role and outcome? What about challenging our hospitals to “prove” that they have a great system with streamlined processes that are BACKED BY DATA?

The problem isn’t going away. Just this week, another study came out emphasizing that we need to get our act together.

This study highlighted the fact that we still have a long way to go. The researchers, spearheaded by Sonja Postma, once again identified the critical importance of minimizing system delays. These delays included factors such as field triage and bypassing the emergency department directly to the heart catherization center. The article also emphasizes the importance of collaborative discussions on process improvement.

The underlying causes of delays can be widespread - from system rules, to transportation issues, to the patients themselves. But, without a standardized data-keeping system, how will you know what element broke down in any given case when analyzing it weeks or months down the road? Because, as the above study points out, system delays significantly increase short-term and long-term mortality in high-risk patients, it is of critical importance that you have an answer to this question. 

So, how is your system doing? How do you qualify good enough? What sets your healthcare system apart from the rest? What data are you tracking? What changes are you making? What improvements have you seen? If you struggle to answer - or are unhappy with your answer to - any of these questions, Pulsara can help.

Share your best practices and wins with us.

Download our Publications!  To see how Pulsara helps eliminate system delays. 


To read more, check out a snapshot from the research:

The influence of system delay on 30-day and on long-term mortality in patients with anterior versus non-anterior ST-segment elevation myocardial infarction: a cohort study

What is already known about this subject?

  • It is known that system delay is independently associated with mortality.

What does this study add?

  • We hypothesised that the effect of system delay on mortality would be most apparent in high-risk patients (patients with an anterior myocardial infarction) compared with low-risk patients (patients with a non-anterior myocardial infarction).

How might this impact clinical practice?

  • Focusing on system delay, especially in high-risk patients, may improve clinical practice since we have demonstrated that prolonged system delay significantly increased short-term as well as long-term mortality in high-risk patients. This effect was not demonstrated in low-risk patients.



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