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Related Experiment Video

Updated: Oct 24, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Reducing potentially avoidable tasks in a hyperacute stroke unit.

Derya Tireli¹, Michael Broksgaard Jensen^2,3

¹Department of Neurology, Stroke Unit, Nordsjaellands Hospital, Hillerod, Denmark derya.tireli@regionh.dk.

BMJ Open Quality

|August 13, 2021

Summary

Reducing night shift tasks for junior doctors in stroke units is crucial. A systematic approach significantly decreased avoidable tasks, improving efficiency and prioritizing high-level patient care.

Keywords:

PDSA control charts/run charts duty hours/work hours quality improvement

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Area of Science:

Neurology
Healthcare Management
Medical Education

Background:

Stroke unit workflows are demanding, particularly during night shifts with reduced staffing.
Junior doctors on call face significant workload due to patient admissions, acute situations, and routine tasks.
Minimizing non-essential tasks is vital for junior doctors to focus on high-priority patient care during night shifts.

Purpose of the Study:

To decrease potentially avoidable tasks for on-call junior doctors during night shifts to one per shift.
To identify and address the primary sources of workload burden for junior doctors overnight.
To enhance the efficiency and effectiveness of stroke unit care delivery during non-daylight hours.

Main Methods:

Investigated common night shift tasks for on-call junior doctors.
Optimized morning and evening rounds to preemptively manage tasks.
Implemented the Plan-Do-Study-Act (PDSA) cycle, incorporating education, knowledge sharing, checklists, and feedback.
Systematically analyzed and improved work routines for doctors and nurses.

Main Results:

Reduced potentially avoidable tasks from a median of 11 to 3 per week for on-call junior doctors.
Demonstrated a significant decrease in the overall workload during night shifts.
Validated the effectiveness of a systematic, iterative improvement process.

Conclusions:

A systematic approach can substantially reduce the workload of on-call junior doctors in stroke units during night shifts.
Improving work routines through targeted interventions enhances efficiency and allows for better focus on critical patient needs.
The PDSA methodology proved effective in optimizing healthcare provider workflows and patient care delivery.