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Time for Balance

Frederick A. Masoudi, MD, MSPH

JAMA. 2007;298(23):2790-2791.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Reperfusion therapy with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) has understandably received considerable attention in quality measurement and improvement initiatives. STEMI is a common condition with high mortality. The benefits of reperfusion therapy can be substantial but are time sensitive.¹ However, important gaps exist between the patterns of treatment in the community and the ideal benchmarks established in evidence-based practice guidelines.² The timeliness of primary PCI, or "door-to-balloon" time, has emerged as one of a handful of quality measures reported to the public for the care of patients with acute myocardial infarction³ and serves as the focus of both regional^4-5 and national initiatives^6-7 to improve care quality.

Although understanding and improving the time to primary PCI in patients with STEMI has been widely accepted as important, this single measure overlooks other critical aspects of the performance of complex systems providing this . . . [Full Text of this Article]

Author Affiliations: Department of Medicine, Division of Cardiology, Denver Health Medical Center, Denver, Colorado; and Department of Medicine, Division of Cardiology, University of Colorado at Denver and Health Sciences Center, Aurora.

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