Abstract W P341: Closing Gaps in Large Vessel Occlusions (LVO) Care: A Performance Improvement Project
Background: Stroke diagnosis and treatment require speed, efficiency, and coordination among different departments. We identified two gaps in our care for LVO patients: Lack of accountability and coordination among involved departments and LVO stroke education in the emergency department (ED).
Purpose: Decrease Door to Groin (DTG) puncture to ≤ 120 minutes.
Methods: We identified all departments involved and created a multidisciplinary team that included: ED, CT, Neuroradiology, Strokologist, and Interventional Radiology. We identified a champion in each department to participate in weekly meetings. We defined time goals within the process of DTG and began to remove barriers in real time. In addition, the ED staff was educated on recognizing LVO, ordering imaging in a timely manner, and preparing a room for code grey alerts. To assess the interventions, we collected DTG times on patients who were treated with tissue plasminogen activator (tPA) and neuro-intervention before and after our project.
Results: Comparing the groups, our average DTG times improved from 209 minutes to 151 minutes, which was a reduction of 58 minutes and a 27.75% decrease. Breaking down department silos and focusing on the patients clinical needs allowed us to unify our stroke team.
Conclusion: Efficient stroke care requires a multidisciplinary team to identify barriers in stroke care, implement simultaneous parallel processes to be activated, communicate among team members, and maintain accountability among departments. With an established team, we are now looking for opportunities to improve our DTG times to ≤120 minutes.
Author Disclosures: C. Basignani: None. G. Anderson: None. S. Napolitano: None. K. Donaldson: None. A. Valez: None. H. Vannes: None. R. Lovec-Theobald: None. A. Bradley: None. C. Garmany: None. C. Dyer: None. E. Bonwit: None. I. Acosta: None.
- © 2015 by American Heart Association, Inc.