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p-Index From 2021 - 2026
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All Journal Journal of Health Service Administration and Hospital Management
Dr Amitha Marla
Director Medical Administration for A J Hospital & Research Centre, Mangalore. India
Health Professions

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Improving Door-to-Balloon Time through Operational Efficiency and Patient Safety Culture in STEMI Patients: A Hospital-Based Quality Improvement Study Dr Swati Rai; Dr Amitha Marla; Dr Manjunath B V; Miss Priyanka K
Journal of Health Service Administration and Hospital Management Vol. 2 No. 2 (2026): July, 2026
Publisher : CV. Get Press Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69855/laceri.v2i2.565

Abstract

Background: Timely reperfusion is critical for reducing myocardial damage and mortality in ST-elevation myocardial infarction (STEMI). In many Indian settings, door-to-balloon (DTB) time remains prolonged due to operational and system-level barriers. Objective: To evaluate whether recommended DTB timelines can be achieved in a tertiary care hospital and to identify and address key delay factors. Methods: A prospective study was conducted in a 400-bed tertiary care hospital in South India (Oct 2018–Oct 2019), followed by an intervention phase (Nov 2019–Jan 2020). Phase I (n=282) identified delays using process mapping and Fishbone analysis. Phase II implemented Lean principles and the Plan–Do–Check–Act (PDCA) cycle. Statistical comparison of means was performed, with p < 0.05 considered significant. Results: Mean DTB time reduced from 372 minutes to 208 minutes (p < 0.05). The proportion achieving DTB <120 minutes increased from 24% to 47%. Shorter DTB times were associated with lower mortality. Conclusion: Structured protocols, early activation systems, and continuous quality improvement can significantly reduce DTB time. However, achieving global benchmarks requires sustained system-level strengthening.
Co-Authors Dr Manjunath B V Dr Swati Rai Miss Priyanka K