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 D2B^TM 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 Alliance^TM, a nationwide network of hospitals, physician champions and strategic partners committed to addressing the D2B^TM challenge. D2B: An Alliance for Quality^TM 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 D2B^TM Participants Workshop was held in March 2007 in conjunction with the ACC Scientific Sessions in New Orleans.  Representatives of participating hospitals heard from both D2B^TM 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 Alliance^TM held its first international launch in Madrid, Spain on April 18, 2007.  During the meeting, the Spanish Cardiology Society pledged its support to the D2B^TM campaign and encouraged all primary PCI hospitals in Spain to enroll.  Over 30 of Spain's primary PCI hospitals attended the launch.