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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
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Improving Regional Stroke Systems of Care
Melissa S Eng1, Anand V Patel2, Richard B Libman2
1The Feinstein Institute for Medical Research, Northwell Health, New York, NY, USA.
Current Atherosclerosis Reports
|October 25, 2017
Summary
Optimizing acute ischemic stroke (AIS) care requires efficient systems. Streamlining processes, improving communication, and using advanced imaging with stent retrievers can significantly reduce treatment times and improve patient outcomes.
Area of Science:
- Neurology
- Emergency Medicine
- Healthcare Systems Engineering
Background:
- Acute ischemic stroke (AIS) care is complex and time-sensitive.
- Rapid advancements in diagnostics and therapeutics necessitate optimized care pathways.
- Existing systems often face delays impacting patient outcomes.
Purpose of the Study:
- To review current diagnostic, therapeutic, and process models for expediting AIS treatment.
- To identify strategies for improving efficiency in acute stroke care networks.
- To highlight the impact of streamlined systems on patient outcomes and healthcare costs.
Main Methods:
- Review of current literature on AIS management.
- Analysis of diagnostic and therapeutic interventions, including advanced imaging and mechanical thrombectomy.
- Evaluation of process models and system-level strategies for stroke care delivery.
Main Results:
- Mechanical thrombectomy with stent retrievers, guided by advanced imaging, is effective for large vessel occlusion (LVO) AIS.
- Significant delays occur during patient transfer and at comprehensive stroke centers (CSCs), negatively affecting outcomes.
- Inter-facility communication, pre-notification, and parallel processing within CSCs can reduce door-to-treatment times.
Conclusions:
- Streamlined stroke systems of care, structured regionally, improve treatment rates and functional outcomes for AIS patients.
- Efficient network management, inter-departmental collaboration, and proactive planning are crucial for maximizing brain salvage.
- Optimized stroke care pathways can lead to better patient outcomes and healthcare cost savings.
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