Simple text-messaging intervention is associated with improved door-to-needle times for acute ischemic stroke

Area of Science:

• Neurology
• Quality Improvement Science
• Health Informatics

Background:

• Timely administration of intravenous tissue-type plasminogen activator (IV tPA) is critical for acute ischemic stroke outcomes.
• Consistent and prompt treatment delivery for stroke remains a significant clinical challenge.
• Developing effective quality improvement interventions is essential for optimizing stroke care pathways.

Purpose of the Study:

• To develop and evaluate a quality improvement intervention aimed at reducing door-to-needle (DTN) times.
• To assess the impact of a text-messaging based intervention on the timeliness of IV tPA administration.
• To improve resident-led Code Stroke team performance at an academic medical center.

Main Methods:

• A simple text-messaging intervention with real-time feedback was implemented.
• The intervention targeted door-to-needle times for patients receiving IV tPA.
• Statistical analysis using rank-sum test and linear regression evaluated changes in DTN times.

Main Results:

• The study included 202 patients (94 preintervention, 108 postintervention).
• Median DTN time significantly decreased from 82 minutes to 56 minutes postintervention (P<0.0001).
• The proportion of patients treated within 60 minutes increased from 16% to 61% (P<0.001).

Conclusions:

• A simple, real-time text-messaging intervention effectively improved DTN times for acute ischemic stroke.
• This quality improvement strategy demonstrates a significant positive impact on stroke treatment efficiency.
• The intervention offers a scalable solution for enhancing acute stroke care delivery.