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 process measure of patients presenting in emergency room 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. Financial implications arising due to delay in processes compel these patients usually to leave ER either without being seen or preferring 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 consultation 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. With the above scenario, the objective of this project was to maximize of 50% improvement in door-to-balloon time of ST segmant elevation in myocardial infarction 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 such as defects, poor quality, or other deficiencies in performance. Approach taken was baseline data abstraction through clinical audit to measure process involved in patient care through process measure as recommended by AHA guideline for management of ST-Elevation. The results obtained were relative frequency/percentage which was calculated by dividing the number of event by the total number of cases and multiplying by 100.