Background Especially in primary percutaneous coronary intervention (PCI), prolonged delays to 1st balloon time are associated with an increased risk of impaired left ventricular systolic function and death. Early application of primary PCI is important to maximize the efficacy of reperfusion therapy in patients with acute myocardial infarction (AMI). We changed the notification cascade to improve the in-hospital time delay. Therefore, we performed this study to evaluate in-hospital time delay before and after AMI team organization. Methods We reviewed charts of 28 patients received primary PCI from March to June 2006 (phase I, before AMI team organization) and 35 patients from March to June 2007(phase II, after AMI team organization). We analyzed various time delays from chest pain onset time, first hospital arrival time, transfer time, emergency room(ER) arrival time, cathroom arrival time and 1st balloon time. Results The mean age(phase I vs. phase II) was 66.7짹11.6 vs. 61.1짹11.7. (p=0.065) Symptom to ER arrival time was 360.8짹259.3 minutes vs. 252.1짹230.2 minutes (p=0.083), door to cathroom time 76.4짹32.5 minutes vs. 51.5짹38.8 minutes (p=0.020) and cathroom to 1st balloon time 21.3짹9.6 minutes vs. 22.3짹10.8 minutes (p=0.699). Conclusions The organization of AMI team including the simplification of the notification cascade and delivery of short message service of AMI patient arrival by cellular phone improved in-hopital time delay, especially door to cathroom arrival time.