Time to ECG in Chest Pain Quality Improvement Project was initiated to address concerns raised by a recent Care Quality Commission (CQC) inspection regarding patient safety in the emergency department (ED). Specifically, the project aimed to reduce the median time it takes to obtain an ECG for patients presenting with chest pain, which was initially 78 minutes, to under 30 minutes. Timely ECG assessment is critical in the early diagnosis and management of chest pain, particularly to rule out life-threatening conditions such as myocardial infarction.
The quality improvement initiative identified key areas for improvement in the ED, including a shortage of Clinical Support Workers (CSWs) and suboptimal triage processes that delayed ECG initiation. To address these challenges, the project prioritized four targeted interventions: it recruited additional Clinical Support Workers (CSWs) to support the clinical team, provided extra training to staff to enhance efficiency and competency in ECG acquisition, established a clear policy that mandated performing ECGs at triage for patients presenting with chest pain, and introduced a Continuous Flow Model to improve cubicle availability and reduce delays in patient movement within the department.
result of these interventions
As a result of these interventions, the median time to obtain an ECG for patients presenting with chest pain improved significantly, decreasing from 78 minutes to 29 minutes, which is just under the target of 30 minutes. This improvement marked a significant milestone in enhancing the efficiency of care delivery within the emergency department (ED). Importantly, the improved time was not a one-time achievement; the ED was able to sustain this improvement consistently, maintaining a performance level below the first quartile for six consecutive data points. This sustained performance reflects the success and lasting impact of the interventions on the department’s workflow and efficiency in responding to chest pain cases.
ECG technicians
Looking toward the future, there are further opportunities to enhance the department’s ability to provide timely ECGs and improve patient care even more. One potential area for improvement is the recruitment of dedicated ECG technicians, which would streamline the process and further reduce the time to ECG by ensuring specialized staff are available to perform tests quickly and accurately. Additionally, with the growing demand for emergency services, transitioning to a new department building could offer the necessary space and infrastructure to accommodate a higher volume of patients, which would reduce overcrowding and help optimize the flow of care.
