CONCLUSIONS
Overall, the six hospitals included in the study exceeded the minimal adherence score of 75% for patients having an ECG in< 10 minutes of admission (83.1%) as well as having a D2B times ≤90 minutes (87.8% of the cases). Nonetheless, it is noteworthy that only two hospitals achieved greater than 90% adherence to a D2B time ≤90 minutes. The two greatest contributors to D2B time identified in the study were patient-related confounders and scenario of admission. While the patient-related confounders cannot be controlled, close collaboration between hospital and EMS personnel is recommended to explore strategies to increase field activations and direct patient transportation to the CCL.