Abstract WP244: The Stroke Interventional Radiology (SIR) Process for Rapid Transport of the Acute Stroke Patient
Background: Expedient transfer of acute stroke patients is imperative for optimizing stroke treatment. Our aim was to develop and evaluate a new process that would provide rapid accessibility to expert advice, multi modality imaging, and interventional stroke treatments.
Methods: In October 2008, members from Interventional Neuroradiology and Stroke neurology identified obstacles that led to delays in acceptance and transfer of patients. the Stroke Interventional Radiology (SIR) processwas developed to streamline the transfer of acute stroke patients.
Results: Before implementation of the SIR process, numerous calls were made to arrange for coordination of care. Communication between the referring physician, stroke neurologist and neuro-interventionalist occurred sequentially. Once a decision was made to accept the patient for transfer, checking for bed availability before approval of the transfer created additional delays. In May 2009, the SIR process was developed to improve rapid access. The process involves coordinated care among the neuro-interventionalist, stroke neurologist, transfer center, hospital administration, radiologist, radiology techs, and crisis nurses and has three main components: 1)the neurologist and interventional neuroradiologist are jointly connected via conference call with the referring physician within five minutes, 2) bed availability for acute stroke transfers is guaranteed, and 3) a paging system provides communication to physicians, nurses, radiology technologists, transport team, and respiratory therapist on patient condition and estimated time of arrival. Since implementation, total time to transfer approval has decreased by 75%. Simultaneously, we have increased the volume of patients transferred (38 in 2010, 59 in 2011 and 21 for first quarter of 2012), the number of acute stroke patients treated with intervention (10, 13, 16, 17 for consecutive years from 2008), and, via phone consultation, the number of patients treated with IV tPA at referring hospitals (3, 2, 19, 28, for consecutive years since 2008 and 12 already for first quarter of 2012).
Conclusion: A system of coordinated care can markedly reduce acute stroke transfer times.
- © 2012 by American Heart Association, Inc.