Reducing Delays in Heart Attack Patients with Six Sigma

Saadia Farooqui*, Dr Khawar Kazmi **
Periodicity:March - May'2020


Despite being a tertiary care hospital and a referral center for complicated & acute patients, the hospital lacked an automated standardized reporting tool and system for processes measures of patients presenting in ER with Acute Chest Pain. All these contribute in creating negative effect on patient satisfaction, direct negative impact on patient outcome, which is well documented in international literature and financial implications such as due to delay in processes compel these patients usually to leave ER either without being seen or prefer to leave against medical advice. Absence of automated standardized reporting tool had resulted in a number of incorrect practices such as late generation of cardiology consult by ER physician, delay in obtaining financial approval from financial counselor prior to admission process and late transfer of patient from ER to Cath lab. The objective of this project was to maximum of 50% improvement in Door to Balloon Time of STEMI patients undergoing Percutaneous Coronary Interventions (PCI) within 90 Minutes of Arrival at a Hospital. The Six Sigma DMAIC process methodology has been selected as its improvement method. A Six Sigma DMAIC project is defined as a project that eliminates a chronic problem that is causing patient dissatisfaction, defects, costs of poor quality, or other deficiencies in performance. Approach taken was baseline data abstraction through clinical audit to measure process involve in patient care through processes measures as recommended by AHA guideline for management of ST-Elevation. The results obtain were relative frequency/percentage which was calculated by dividing the number of event by the total number of cases and multiplying by 100. Displaying the data summary was display through bar charts & variation and trend over time through control charts.


Six Sigma, Heart Attack, Quality Improvement, Door to Balloon Time

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