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Related Experiment Video

Updated: Feb 7, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Enhancing acute stroke services: a quality improvement project.

Keith McGrath1, Nora Cunningham1, Elizabeth Moloney1

  • 1Department of Geriatric Medicine, University Hospital Limerick, Limerick, Ireland.

BMJ Open Quality
|July 19, 2018
PubMed
Summary

Implementing a dedicated stroke team and pathway significantly reduced door-to-needle times for acute ischemic stroke patients. This quality improvement initiative enhanced timely thrombolysis, improving patient outcomes in a busy hospital setting.

Keywords:
healthcare quality improvementhospital medicinequality improvement

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Area of Science:

  • Neurology
  • Quality Improvement Science
  • Healthcare Management

Background:

  • Acute stroke care in Ireland was managed by general physicians, potentially leading to delays.
  • Rapid intervention is critical for favorable outcomes in acute ischemic stroke patients.

Purpose of the Study:

  • To enhance acute stroke services by reducing door-to-needle (DTN) time to under 60 minutes for eligible patients by December 2016.
  • To implement a quality improvement project in a university hospital setting.

Main Methods:

  • Utilized a mixed-methods approach, including process mapping and driver diagrams.
  • Employed Plan-Do-Study-Act cycles to test interventions.
  • Compared DTN times before and after the introduction of a new stroke team and pathway.

Main Results:

  • Thrombolysis rates increased from 7.8% to 13.5% between the two study periods.
  • Median door-to-needle time decreased from 99 minutes to 43.5 minutes.
  • The introduction of a dedicated stroke team improved efficiency and timeliness of care.

Conclusions:

  • Quality improvement techniques successfully enhanced acute stroke care, leading to sustained improvements.
  • A structured protocol, continuous staff education, and effective communication were key to mitigating delays.
  • The described approach offers a valuable model for improving other hospital services.