Related Experiment Video
Updated: Apr 21, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Simple text-messaging intervention is associated with improved door-to-needle times for acute ischemic stroke
Molly M Burnett1, Lara Zimmermann1, Zlatan Coralic1
1From the Departments of Neurology (M.M.B., L.Z., A.S.K.), Emergency Medicine (T.Q., W.W.), and Clinical Pharmacy (Z.C.), University of California, San Francisco.
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.
