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 What is D2B?

D2B: An Alliance for QualityTM is a new Guidelines Applied in Practice (GAP) program launched by the American College of Cardiology (ACC) to save time and save lives by reducing the door-to-balloon times in U.S. hospitals performing primary PCI.  A growing list of other organizations, including the American Heart Association (AHA) and the National Heart Lung and Blood Institute, are partners in this effort.

National guidelines developed by the American College of Cardiology (ACC) and the American Heart Association (AHA) state that hospitals treating STEMI patients with emergency PCI should reliably achieve a door-to-balloon time of 90 minutes or less. However, accomplishing this level of performance is an organizational challenge.

The D2B AllianceTM was developed to make what is current extraordinary performance ordinary by providing hospitals with key evidence-based strategies and supporting tools needed to begin reducing their D2BTM times. More importantly, it provides an open, vibrant community for hospitals to share their findings and experiences and reward excellence.

The D2B AllianceTM offers something for all participants, whether a hospital is already well on its way to reducing D2BTM times or just beginning.  Your hospital can join the community of about 1,100 hospitals already enrolled in D2BTM

If your facility has not yet registered it's not too late.  Sign up via the web now!  

For more information on the D2B AllianceTM email or click here to join.

 Campaign History

In January 2006, the American College of Cardiology (ACC) recognized the urgent need to reduce door-to-balloon times for patients experiencing ST-segment elevation myocardial infarction (STEMI). A work group was formed to review this complex issue and develop an ACC national initiative based on the following goal:


To achieve a door-to-balloon time of </= 90 minutes for at least 75 percent of non-transfer primary PCI (percutaneous coronary intervention) patients with ST-segment elevation myocardial infarction in all participating hospitals performing primary PCI.


While D2BTM measures have been in place for some time, only 40 percent of hospitals have been able to consistently perform primary PCI in less than 90 minutes. Highly successful precursors to this initiative, such as the nationally recognized ACC AMI and CHF GAP projects showed that adherence rates for AMI and HF core measures could be enhanced by implementing standardized toolkits and systematic processes of care. 


In June 2006, the ACC began building the D2B AllianceTM, a nationwide network of hospitals, physician champions and strategic partners committed to addressing the D2BTM challenge. D2B: An Alliance for QualityTM formally launched in November 2006 at the American Heart Association annual meeting. This rapidly expanding learning community is committed to working together to provide the tools, information and support necessary to help hospitals achieve their goals and improve outcomes in this critical area.


The first D2BTM Participants Workshop was held in March 2007 in conjunction with the ACC Scientific Sessions in New Orleans.  Representatives of participating hospitals heard from both D2BTM faculty and successful hospitals on how they were able to achieve improved door-to-balloon times.  The list of participating hospitals was also released to the public for the first time during this workshop. 

The D2B AllianceTM held its first international launch in Madrid, Spain on April 18, 2007.  During the meeting, the Spanish Cardiology Society pledged its support to the D2BTM campaign and encouraged all primary PCI hospitals in Spain to enroll.  Over 30 of Spain's primary PCI hospitals attended the launch.

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