OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period. The primary outcome was mean DTN times before and after initiating Stop Stroke. Secondary outcome was the effect on the DTN≤60-minute benchmark. RESULTS: During the study period, there were 533 stroke activations (200 before Stop Stroke implementation and 333 after). A total of 68 patients meeting inclusion criteria were analyzed (34 pre-app and 34 post- app). The observed mean DTN times post-app decreased 21 minutes (77 to 56 minutes), a 28% improvement (P=.001). Further, the patients meeting DTN≤60 minutes improved from 32% (11 of 34) to 82% (28 of 34) after the app's implementation. CONCLUSIONS: In this cohort of patients with AIS, Stop Stroke improved mean DTN times and number of patients treated within 60 minutes of arrival. These results demonstrate the app's effect of increasing awareness of suspected AIS and improving coordination of care, evidenced by the magnitude of its effect on treatment times. Dickson R , Nedelcut A , McPeek Nedelcut M . Stop Stroke: a brief report on door-to-needle times and performance after implementing an acute care coordination medical application and implications to Emergency Medical Services. Prehosp Disaster Med. 2017;32(3):343-347.
OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period. The primary outcome was mean DTN times before and after initiating Stop Stroke. Secondary outcome was the effect on the DTN≤60-minute benchmark. RESULTS: During the study period, there were 533 stroke activations (200 before Stop Stroke implementation and 333 after). A total of 68 patients meeting inclusion criteria were analyzed (34 pre-app and 34 post- app). The observed mean DTN times post-app decreased 21 minutes (77 to 56 minutes), a 28% improvement (P=.001). Further, the patients meeting DTN≤60 minutes improved from 32% (11 of 34) to 82% (28 of 34) after the app's implementation. CONCLUSIONS: In this cohort of patients with AIS, Stop Stroke improved mean DTN times and number of patients treated within 60 minutes of arrival. These results demonstrate the app's effect of increasing awareness of suspected AIS and improving coordination of care, evidenced by the magnitude of its effect on treatment times. Dickson R , Nedelcut A , McPeek Nedelcut M . Stop Stroke: a brief report on door-to-needle times and performance after implementing an acute care coordination medical application and implications to Emergency Medical Services. Prehosp Disaster Med. 2017;32(3):343-347.
Entities:
Keywords:
AIS acute ischemic stroke; CMS Center for Medicare and Medicaid Services; DTN door-to-needle; ED emergency department; EMS Emergency Medical Services; OTT onset-to-treatment; TPA Tissue Plasminogen Activator; acute care coordination; mobile technology; stroke; therapy
Authors: Chris F Bladin; Kathleen L Bagot; Michelle Vu; Joosup Kim; Stephen Bernard; Karen Smith; Grant Hocking; Tessa Coupland; Debra Pearce; Diane Badcock; Marc Budge; Voltaire Nadurata; Wayne Pearce; Howard Hall; Ben Kelly; Angie Spencer; Pauline Chapman; Ernesto Oqueli; Ramesh Sahathevan; Thomas Kraemer; Casey Hair; Dion Stub; Dominique A Cadilhac Journal: BMJ Open Date: 2022-07-18 Impact factor: 3.006
Authors: Laurien S Kuhrij; Michel Wjm Wouters; Renske M van den Berg-Vos; Frank-Erik de Leeuw; Paul J Nederkoorn Journal: Eur Stroke J Date: 2018-07-11