Related Experiment Video
Updated: Mar 17, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Simple In-Hospital Interventions to Reduce Door-to-CT Time in Acute Stroke
Elyar Sadeghi-Hokmabadi1, Aliakbar Taheraghdam1, Mazyar Hashemilar1
1Neuroscience Research Center, Imam Reza Hospital, Tabriz University of Medical Science, Daneshgah Street, Tabriz, East Azerbaijan, Iran.
Insights
Simple hospital interventions significantly cut door-to-CT times for acute ischemic stroke patients. This led to a 62.4% success rate in achieving the crucial door-to-needle time goal for effective treatment.
Area of Science:
- Neurology
- Quality Improvement
- Emergency Medicine
Background:
- Acute ischemic stroke requires timely treatment with intravenous tissue plasminogen activator.
- Delays in treatment increase morbidity and mortality.
- Reducing door-to-CT and door-to-needle times is critical for effective stroke care.
Purpose of the Study:
- To evaluate the impact of simple in-hospital interventions on reducing door-to-CT (DTC) time.
- To assess the achievement of a door-to-needle (DTN) time of less than 60 minutes for acute ischemic stroke patients.
Main Methods:
- A pre-intervention period recorded DTC times for 213 patients.
- Five quality improvement interventions were implemented: call notification, CT scan prioritization, lab analysis prioritization, dedicated stroke bed, and staff education.
- Post-intervention DTC and DTN times were recorded for 276 and 106 patients, respectively.
Main Results:
- Median DTC time significantly decreased from 75 minutes pre-intervention to 20 minutes post-intervention (P < 0.001).
- Post-intervention, the median DTN time was 55 minutes.
- 62.4% of patients achieved a DTN time of less than 60 minutes (P < 0.001).
Conclusions:
- The implemented interventions effectively reduced DTC time.
- The interventions resulted in an acceptable DTN time, with a significant proportion of patients meeting the <60 minute goal.
- These feasible interventions can be adopted by most hospitals to improve acute stroke care.
Abstract:
Background. Intravenous tissue plasminogen activator, a time dependent therapy, can reduce the morbidity and mortality of acute ischemic stroke. This study was designed to assess the effect of simple in-hospital interventions on reducing door-to-CT (DTC) time and reaching door-to-needle (DTN) time of less than 60 minutes. Methods. Before any intervention, DTC time was recorded for 213 patients over a one-year period at our center. Five simple quality-improvement interventions were implemented, namely, call notification, prioritizing patients for CT scan, prioritizing patients for lab analysis, specifying a bed for acute stroke patients, and staff education. After intervention, over a course of 44 months, DTC time was recorded for 276 patients with the stroke code. Furthermore DTN time was recorded for 106 patients who were treated with IV thrombolytic therapy. Results. The median DTC time significantly decreased in the postintervention period comparing to the preintervention period [median (IQR); 20 (12-30) versus 75 (52.5-105), P < 0.001]. At the postintervention period, the median (IQR) DTN time was 55 (40-73) minutes and proportion of patients with DTN time less than 60 minutes was 62.4% (P < 0.001). Conclusion. Our interventions significantly reduced DTC time and resulted in an acceptable DTN time. These interventions are feasible in most hospitals and should be considered.
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:28Acute Coronary Syndrome IV: Interprofessional Care