Chest Pain Center Continuous Improvement Acute Myocardial Infarction Treatment
江苏省医院协会医院管理创新专项研究课题（JSYGY-2-2021-JZ50）
目的：研究胸痛中心持续改进机制对急性ST段抬高型心肌梗死（STEMI）患者救治的影响。方法：医院于2020年9月开展胸痛中心持续改进活动，实施搭建心电网络平台、增设胸痛专科门诊、召开联席会议、丰富胸痛知识宣教方式等措施，将2020年1月至6月我院收治的113例STEMI患者设为持续改进前的对照组，将2021年同期收治的128例STEMI患者设为持续改进后的观察组，对比两组STEMI患者救治的质控指标和经济学指标。结果：持续改进后，观察组较对照组远程心电图传输比例和绕行急诊比例有所提升，差异均有统计学意义（P＜0.05）。完成首份心电图至确诊时间、入门至球囊扩张时间、首次医疗接触至球囊扩张时间、住院天数均明显缩短，差异均有统计学意义（P＜0.05）。结论：我院胸痛中心持续改进机制进一步缩短了急性ST段抬高型心肌梗死患者的救治时间，为患者提供了快速准确的诊断，缩短了住院天数，降低了患者经济负担。
Objective：To study the effect of continuous improvement mechanism of chest pain center on the treatment of patients with acute ST-segment elevation myocardial infarction. Methods：In September 2020，the hospital carried out continuous improvement activities for building the ECG network platform，adding the chest pain specialist clinic，holding a joint meeting，and enriching the chest pain knowledge education methods.113 patients with STEMI admitted to our hospital from January 2020 to June 2020 were selected as control group before continuous improvement，and 128 patients with STEMI admitted to our hospital from January 2021 to June 2021 were selected as observation group after continuous improvement.The quality control indicators and economic indicators were compared between the two groups. Results：After continuous improvement，the proportion of remote ECG transmission and emergency detour in the observation group was increased compared with the control group，and the differences were statistically significant（P < 0.05）. The time from completion of the first ECG to diagnosis，the time from induction to balloon dilation，the time from first medical contact to balloon dilation and the length of hospital stay were significantly shortened，with statistical significance（P < 0.05）. Conclusions：The continuous improvement mechanism of chest pain center in our hospital can further shorten the treatment time of patients with acute ST-segment elevation myocardial infarction，provide patients with rapid and accurate diagnosis，shorten the length of hospitalization，reduce the economic burden of patients.