Using a quality improvement process to create measurable improvement in care delivery for acute stroke

Area of Science:

• Neurology
• Cardiovascular Medicine
• Emergency Medicine

Background:

• Thrombolytic therapy, specifically tissue plasminogen activator (t-PA), is a cornerstone in managing acute ischemic stroke.
• Timely administration of t-PA within 4.5 hours of stroke onset is critical for reperfusion and improved patient outcomes.
• Hamilton Health Services (HHS) aimed to align its acute stroke care with established guidelines and readiness criteria.

Purpose of the Study:

• To describe the quality improvement process implemented at HHS to optimize acute stroke care.
• To ensure timely administration of thrombolytic therapy to stroke patients upon hospital arrival.

Main Methods:

• Development and implementation of a quality improvement initiative focused on reducing door-to-needle time for thrombolytic therapy.
• Systematic monitoring and analysis of patient data to track adherence to the 60-minute treatment goal.
• Process redesign to streamline patient flow and interdisciplinary collaboration within the stroke care pathway.

Main Results:

• Successful implementation of a quality improvement process at HHS.
• Demonstrated ability to administer thrombolytic therapy within 60 minutes of patient arrival for acute ischemic stroke.
• Enhanced readiness and adherence to best practices in regional acute stroke care.

Conclusions:

• The quality improvement process effectively facilitated timely thrombolytic therapy administration.
• HHS achieved its goal of meeting critical readiness criteria for acute stroke management.
• This initiative contributes to improved outcomes for patients experiencing acute ischemic stroke.