Comparing hospital performance in door-to-balloon time between the Hospital Quality Alliance and the National Cardiovascular Data Registry.

H c fi o the Editor: Data on hospital performance in door-to-balloon DTB) times for patients with ST-segment elevation myocardial nfarction (STEMI) are now collected and reported by numerous rganizations, including the Centers for Medicare and Medicaid ervices (CMS), The Joint Commission, and the American ollege of Cardiology (1–3). Despite proliferation of these efforts o report DTB time, its consistency across data sources has not been xamined. Accordingly, we compared performance rankings for hositals on DTB time using 2 prominent national data sources: 1) the ospital Quality Alliance (HQA, a consortium of organizations ncluding CMS and the Joint Commission; and 2) the National ardiovascular Data Registry’s (NCDR) CathPCI Registry. Data collected on DTB time from HQA and NCDR between anuary and December 2005 were used for this analysis. Data from HQA eflected 1,407 U.S. hospitals performing percutaneous coronary interention (PCI) and 51,887 patients; data from NCDR reflected 456 ospitals and 19,697 patients. We excluded hospitals reporting fewer than 0 patients (n 338 for HQA; n 118 for NCDR) and those not eporting in all 4 quarters of 2005 (n 19 for HQA; n 62 for NCDR). f the remaining, 35 hospitals could not be matched using unique dentifiers, yielding 241 for direct comparison. In 2005, DTB time in HQA was assessed as the time from ospital arrival to angioplasty balloon inflation in patients with TEMI or new left bundle branch block on the electrocardiogram erformed closest to hospital arrival and in whom successful PCI as performed within 24 hours of admission. When use of an ngioplasty balloon was not documented, the earliest time reorded for a wire or other alternative device reaching a lesion was sed instead. In NCDR, DTB time was assessed using slightly ifferent criteria than those described above. Specifically, it was easured as the time from hospital arrival to the first attempt at reperfusion” in patients with STEMI clinically identified as