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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Published on: January 15, 2017

Decreasing Stroke Code to CT Time in Patients Presenting with Stroke Symptoms.

Aleksandrs Kalnins1, L Jake Mickelsen1, Daisha Marsh1

  • 1From the Departments of Radiology (A.K., L.J.M., D.M., C.Z., M.W., D.B.L.), Neurology and Neurological Sciences (S.C., N.V.), and Emergency Medicine (G.O.), Stanford University School of Medicine, Stanford Hospital and Clinics, Stanford, Calif; and Neuroscience Service Line, Department of Medicine, Christiana Care Health System, Newark, Del (W.A.T.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|August 19, 2017
PubMed
Summary

Quality improvement programs effectively reduced stroke code to computed tomography (CT) scan times for emergency department patients. This initiative improved patient care by decreasing the time from stroke code activation to CT imaging.

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Area of Science:

  • Neurology
  • Radiology
  • Healthcare Management

Background:

  • Stroke code to computed tomography (CT) times are critical for timely stroke diagnosis and treatment.
  • Optimizing this workflow is essential in comprehensive stroke centers, especially for non-prenotified emergency department (ED) patients.
  • Current processes may lead to delays, impacting adherence to door-to-CT time guidelines.

Purpose of the Study:

  • To decrease the mean stroke code to CT time for non-prenotified ED stroke patients.
  • To achieve a target time of less than 15 minutes from a baseline of 20 minutes.
  • To enhance the consistent achievement of the 25-minute door-to-CT time guideline.

Main Methods:

  • Implementation of a structured quality improvement (QI) program utilizing a multidisciplinary team approach.
  • Application of QI methods to identify key process drivers and implement targeted interventions.
  • Focus on non-prenotified emergency department patients presenting with stroke symptoms.

Main Results:

  • The mean stroke code to CT time for non-prenotified patients was reduced to less than 14 minutes.
  • Significant decrease achieved within an 18-week intervention period.
  • Facilitated more consistent adherence to the door-to-CT time guideline.

Conclusions:

  • Guided QI programs are effective in streamlining stroke code to CT times.
  • Multidisciplinary team-based QI interventions can significantly reduce critical time intervals for stroke patients.
  • The reported methods can be replicated to improve CT imaging efficiency in emergency departments for stroke patients.