Ouachita County Medical Center (OCMC) is a not-for-profit hospital with 99 beds, serving residents of the rural community surrounding the city of Camden in southern Arkansas, about 100 miles from Little Rock. As a smaller, non-PCI facility, OCMC often coordinates transfers for their STEMI patients to PCI facilities.
Previously, when a patient arrived in the OCMC emergency room with a STEMI, whether by ambulance or private car, staff would first page a cardiologist at the patient’s preferred receiving facility, then wait for the physician to call back. Only then could they start the process of transferring the patient to a percutaneous coronary intervention (PCI) facility that could provide critical care. “Then we had to get a bed confirmed, and then we had to wait to get our EMS service to take the patient. And then, usually, most of those patients at that time went to Little Rock, which is about an hour and a half from where we are,” explained Jennifer Ray, RN, OCMC’s ER and ICU manager. “So the timeliness of the patient getting in and out was very, very slow.” How slow? During 2017, the average door-in, door-out (DIDO) time was 72 minutes for the 19 STEMI patients who came into the OCMC ER—more than double the 30 minutes or less recommended by the American College of Cardiology Foundation and the American Heart Association.
