IMPLICATION FOR PRACTICE
Results of this study corroborate those of other investigators in regard to reducing D2B time by achieving STEMI activation in the field as opposed to in the ED. Further, our recommendation to collaborate with EMS personnel to accomplish these outcomes is supported by findings from a study reported by a group of physicians and nurses in South Carolina.31 These investigators were able to significantly lower D2B times by empowering EMS providers to activate the CCL prior to reaching the hospital. By so doing, there were able to reduce their baseline D2B time from 52.5 minutes in 2011 to sustained D2B times under 40 minutes over the next four consecutive years.
Results from this study also emphasize the need for STEMI coordinators to diligently promote precise documentation of STEMI logs to identify potential problem areas in the implementation of STEMI guidelines. They need to look for non-patient-related barriers that may impact D2B times in their respective clinical sites and explore options for removing these barriers to promote timely care of these patients. Documentation of socioeconomic status on STEMI logs would be helpful in clarifying how this variable may contribute to treatment delays.