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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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Published on: January 18, 2018

Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients.

Joonsang Yoo¹, Dongbeom Song¹, Jang-Hyun Baek¹

¹Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.

International Journal of Stroke : Official Journal of the International Stroke Society

|March 27, 2016

Summary

A code stroke program significantly reduced treatment times for in-hospital stroke patients. This initiative improved evaluation and reperfusion therapy, leading to faster interventions for stroke care.

Keywords:

Stroke computerized physician order entry in-hospital stroke quality improvement reperfusion thrombolysis

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Area of Science:

Neurology
Hospital Administration
Public Health

Background:

In-hospital stroke occurs during hospital admission, and timely treatment is crucial.
Patients with in-hospital stroke are candidates for reperfusion therapy but often face treatment delays.
Rapid intervention is essential to improve outcomes for stroke patients.

Purpose of the Study:

To evaluate the effectiveness of a code stroke program in reducing treatment times for in-hospital stroke.
To assess the impact of a program involving computerized physician order entry, specific protocols, and staff education.
To compare treatment intervals before and after program implementation.

Main Methods:

Implementation of a code stroke program in cardiology and cardiovascular surgery departments.
Utilized computerized physician order entry, specific evaluation/treatment protocols, and staff education.
Compared time intervals (onset to evaluation/reperfusion) pre- and post-program in target vs. other wards.

Main Results:

Significant reductions in time from symptom onset to neurology notification (50 vs. 28 min) and brain imaging (91 vs. 41 min).
Decreased time from symptom recognition to notification (22 vs. 9 min).
Substantial reductions in time to intravenous tissue plasminogen activator (tPA) administration (120 vs. 65 min) and arterial puncture (295 vs. 165 min).

Conclusions:

A comprehensive code stroke program, including computerized physician order entry, effectively reduces evaluation and reperfusion times for in-hospital stroke.
The program demonstrated significant improvements in treatment timeliness within targeted hospital departments.
The findings support the adoption of such programs to enhance stroke care efficiency.