Abstract W P15: Decreasing Time to Treatment in Endovascular Therapy for Acute Ischemic Stroke: A Single Institution’s Experience
Background and Purpose: Time has consistently been cited as a fundamental variable to improve clinical outcomes in stroke. We identified potential to reduce ‘Door to Imaging’ and ‘Door to Groin Puncture’ times at our institution by streamlining the flow process for acute stroke management by the multidisciplinary team.
Methods: Retrospective analysis was performed over a 3-month period on all patients who underwent mechanical thrombectomy for symptomatic stroke. Time-interval metrics collected included time from patient arrival to the start of imaging, start of groin puncture and start of revascularization. We then identified weak links in the pathway of stroke care and implemented strategies for change, including early notification of the interventionist by stroke neurologists or the ‘Code Neuro’ stroke nurse, the patient being taken directly to CT on arrival to the Emergency Department if hemodynamically stable and point of care processing of blood tests. Other interventions included enhancement of pre-hospital work-up by Emergency Medical Services and a unified paging system. Following these interventions, another analysis of time-interval metrics was undertaken on a second population of patients, also over a 3-month period.
Results: Data on a total of 20 patients prior to change implementation and 22 patients after change were analyzed. The results obtained are tabulated as shown:
Conclusion: This quality improvement project was able to successfully demonstrate a reduction in various time-interval metrics following a targeted, and ongoing, initiative to optimize specific response mechanisms in the acute stroke process pathway.
Author Disclosures: V.A. Shah: None. A.M. Hawkins: None. W.E. Holloway: None. C.O. Martin: None. N. Akhtar: None.
- © 2015 by American Heart Association, Inc.