D2B: An Alliance for QualityTM advocates the adoption of six key, evidenced-based strategies for reducing door-to-balloon times. The six core strategies are:
- ED physician activates the cath lab;
- One call activates the cath lab;
- Cath lab team ready in 20 – 30 minutes;
- Prompt data feedback;
- Senior management commitment;
- Team-based approach.
A pre-hospital ECG to activate the cath lab is optional. These strategies were selected because of the evidence base and their feasibility. While other strategies exist, including having a cardiologist in the hospital 24/7, they are not required for participation in the D2BTM campaign.