Under the leadership of Damian Gulbransen, DNP, MBA, RN, NEA‑BC, Director of Emergency Services, the Kaiser Permanente Santa Rosa Emergency Department implemented a groundbreaking workflow to reduce door-to-EKG times, significantly improving care for ST Elevation Myocardial Infarction (STEMI) patients.
The key initiatives of this project included the creation of a dedicated EKG Technician role, an additional Emergency Department (ED) technician was assigned solely to performing EKGs, ensuring rapid response and efficiency. Additionally, the team created a standardized Rapid Cardiac Assessment Workflow streamlining the process from patient arrival to EKG completion and transfer, enabling faster identification and treatment of STEMI cases.
The measurable outcomes included:
- Reduced Door-to-Transfer Times: The time required to transfer STEMI patients to specialized receiving centers decreased by nearly 10 minutes.
- Shorter Door-to-EKG Times: The new workflow demonstrated a significant reduction in the time required to perform EKGs upon patient arrival.
- Decreased Length of Stay: STEMI patients experienced shorter stays in the ED, allowing for faster access to specialized care.
- Prior to the project, in 2023, 28% of chest pain patients and 30% of STEMI patients did not receive an EKG within 10 minutes of arrival. Following implementation, compliance with door-to-EKG times under 10 minutes increased to 86% for chest pain patients and 100% for STEMI patients over four months.
The KP SRO ED team exemplifies Kaiser Permanente’s commitment to improving outcomes through innovation, teamwork, and evidence-based practice. Their efforts set a new standard for prompt cardiac care and highlight the importance of multidisciplinary collaboration in achieving best-in-class patient outcomes.