Abstract W P269: Collaboration in the Emergency Department Improves Stroke Care
Introduction: The purpose of this project is to improve the timeliness of stroke care at University Hospitals Comprehensive Stroke and Cerebrovascular Center (UHCSCC). Several projects were implemented in the Emergency Department (ED): Brain Attack (BAT) Lab Turnaround, ED Medic Role Revision, Standardized Handoff Tool and Dedicated Stroke Patient Room.
Methods: First, the BAT lab project addressed the need to expedite lab results since there was no prioritization of specimens. Working with a multidisciplinary team including the ED Lab Quality committee, a new process was developed for the BAT labs using a colored requisition. Second, the ED Medic role was identified to assist with communication of incoming transfers At UHCSCC communication of all patients arriving by EMS or transfers from other facilities is directed through the UH Transfer Center. With an average of 150 patients arriving per day, this requires 8.1 hours of telephone calls placed to the ED charge nurse a month. Third, documentation of the handoff from transporting personnel was written inconsistently in multiple locations. A standardized hand off form was implemented for the nurse to obtain consistent and readily available information to provide efficient care for the stroke patient. Finally, when a new ED was built in 2011, a dedicated stroke room was designed with an attaching CT scanner to further improve the time of diagnosis for the stroke patient.
Results: With the new prioritization process for lab specimens, the turnaround times dramatically improved. Average result times decreased by 23 minutes for CBC, 47 minutes for BMP and 35 minutes for PT/ INR. The Medic role revision decreased the telephone calls placed to the ED charge nurse by 5.5 hours a month to allow more time spent assisting with patient care. Handoff documentation improved from 33% to 90% compliance. Finally, in the new ED with the stroke room attached to the CT scanner, the average time from arrival to CT completion decreased from average of 32 to 20 minutes.
Conclusions: The implementation of the BAT Lab Turnaround, ED Medic Role Revision, Standardized Handoff Tool and Dedicated Stroke Patient Room projects have all demonstrated that collaboration between the ED and other disciplines has improved the stroke care provided.
Author Disclosures: J.M. Fussner: None. K. Awadallah: None.
- © 2014 by American Heart Association, Inc.