Table 2. Comparison of ECG process metrics between the first and second cycles.
The key ECG process metrics between the first and second audit cycles are compared. It highlights significant improvements in ECG acquisition time, documentation quality, and diagnostic accuracy, with areas needing further focus identified. Statistical tests used include chi-square (χ²) tests for categorical comparisons (such as proportions of documented elements and diagnosis frequencies) and an independent samples t-test for comparison of means (e.g., average time to ECG acquisition). A p value of less than 0.05 was considered statistically significant
ECG: electrocardiogram; ACS: acute coronary syndrome
| Parameter | First cycle | Second cycle | Change | Interpretation | Test statistic | p value | |
| Time from arrival to ECG acquisition | ≤10 minutes | 1 (4%) | 18 (81.8%) | 77.8% | More patients received ECGs within the recommended 10-minute window | χ² = 22.78 | <0.001 |
| Average time (minutes) | 29.84 | 3.1 | -89.6% | Significant reduction in time to ECG acquisition | - | - | |
| Documentation quality | Rhythm documented | 8 (32%) | 20 (90.9%) | 58.9% | Dramatic improvement in rhythm documentation | χ² = 8.89 | 0.003 |
| Rate documented | 11 (44%) | 22 (100%) | 56% | All patients had heart rates documented in the second cycle | χ² = 6.86 | 0.009 | |
| ST-segment documented | 5 (20%) | 22 (100%) | 80% | Complete improvement in ST-segment documentation | χ² = 21.97 | <0.00001 | |
| PR interval documented | 5 (20%) | 3 (13.6%) | -6.4% | Minimal decline, indicating a need for further focus | χ² = 0.58 | 0.446 | |
| QRS complex documented | 6 (24%) | 5 (22.7%) | -1.3% | Slight decline, suggesting room for improvement | χ² = 0.11 | 0.742 | |
| Axis documented | 5 (20%) | 15 (68.2%) | 48.2% | Significant improvement in axis documentation | χ² = 5.69 | 0.017 | |
| No elements documented | 13 (52%) | 0 (0%) | -52% | Complete improvement; all cases had some level of documentation in the second cycle | - | - | |
| Diagnostic findings | Normal ECG | 1 (4.5%) | 7 (28%) | 23.5% | Increase in normal ECG findings, possibly due to better screening | χ² = 3.78 | 0.052 |
| ACS | 12 (54.4%) | 6 (24%) | -30.4% | Fewer ACS diagnoses, possibly reflecting improved diagnostic accuracy | χ² = 4.23 | 0.040 | |
| Other causes (not ACS) | 9 (40.9%) | 12 (48%) | 7.1% | Slight increase in non-ACS diagnoses | - | - | |