The Stroke Chronometer-A New Strategy to Reduce Door-to-Needle Time

Area of Science:

• Emergency Medicine
• Neurology
• Clinical Quality Improvement

Background:

• Timeliness is critical in acute stroke treatment, directly impacting patient outcomes.
• Reducing door-to-needle time (DNT) is a key focus for enhancing treatment efficacy and prognosis.
• Existing protocols aim to expedite care, but further optimization is needed.

Purpose of the Study:

• To evaluate the impact of a novel countdown timer system on door-to-computed tomography time (DCTT) and DNT in acute stroke patients.
• To assess the effectiveness of a real-time intervention in streamlining emergency stroke care pathways.

Main Methods:

• A protocol was implemented activating a countdown timer upon acute stroke patient admission.
• Door-to-computed tomography time (DCTT) and door-to-needle time (DNT) were compared pre- and post-implementation.
• Multivariate analysis adjusted for patient demographics and stroke characteristics was performed.

Main Results:

• The Stroke Chronometer implementation led to a significant reduction in mean DCTT from 27.1 to 18.4 minutes (P=.004).
• Mean DNT also decreased significantly from 52.7 to 39.2 minutes (P=.016).
• The protocol successfully enrolled 58% of eligible patients in the second half of the study period.

Conclusions:

• The Stroke Chronometer strategy is an effective method for reducing DCTT and DNT in acute stroke management.
• This intervention demonstrates a successful approach to improving critical care timelines for stroke patients.