A Simple Text-Messaging Intervention Is Associated With Improved Door-to-Needle Times for Acute Ischemic Stroke
Background and Purpose—Timely administration of intravenous tissue-type plasminogen activator (IV tPA) is associated with improved outcomes for acute ischemic stroke; yet, developing processes to consistently provide prompt treatment remains a challenge. We developed and evaluated a simple quality improvement intervention designed to improve door-to-needle (DTN) times for resident-led Code Stroke teams at an academic medical center.
Methods—We evaluated a simple text-messaging based intervention with real-time feedback to improve DTN times for intravenous tissue-type plasminogen activator. We used the rank-sum test and linear regression to evaluate for a change in DTN times that was temporally associated with the rollout of the intervention.
Results—A total of 202 patients received intravenous tissue-type plasminogen activator; 94 preintervention and 108 postintervention. The median DTN time was significantly lower in the postintervention period (56 minutes [interquartile range 44–71] versus 82 minutes [IQR 68–103], P<0.0001) and a significantly higher proportion of patients were treated within 60 minutes (61% versus 16%, P<0.001).
Conclusions—A simple real-time text-messaging intervention was associated with a significant improvements in DTN times for acute ischemic stroke.
- Received September 2, 2014.
- Revision received September 25, 2014.
- Accepted September 25, 2014.
- © 2014 American Heart Association, Inc.