Effects of Workflow Optimization in Endovascularly Treated Stroke Patients - A Pre-Post Effectiveness Study

Area of Science:

• Neurology
• Interventional Radiology
• Healthcare Management

Background:

• Endovascular treatment is standard for acute ischemic stroke with large artery occlusion.
• Early reperfusion is critical for favorable clinical outcomes.
• Interdisciplinary collaboration is key to optimizing patient care pathways.

Purpose of the Study:

• To analyze the impact of an interdisciplinary standard operating procedure (SOP) on periprocedural timings in endovascular stroke treatment.
• To evaluate the influence of workflow optimization on clinical outcomes in acute ischemic stroke patients.
• To assess the effectiveness of streamlined patient management in reducing treatment delays.

Main Methods:

• Retrospective analysis of prospectively maintained stroke database from a university hospital.
• Comparison of periprocedural time intervals and clinical outcomes before and after SOP implementation in 2014.
• Data included 368 patients undergoing endovascular treatment (278 pre-SOP, 90 post-SOP).

Main Results:

• Significant reduction in time from symptom onset to reperfusion (median 264 min pre-SOP vs. 211 min post-SOP, P<0.001).
• Substantial decrease in time from hospital admission to groin puncture (median 121 min pre-SOP vs. 64 min post-SOP, P<0.001).
• Improved clinical outcome measured by modified Rankin Scale (OR 0.56, P=0.038) after SOP implementation.

Conclusions:

• Workflow optimization and interdisciplinary teamwork significantly reduce treatment times for acute ischemic stroke.
• Streamlined processes, including faster imaging and patient transfer, improve reperfusion.
• Optimized workflow leads to better functional outcomes for patients undergoing endovascular stroke treatment.