Optimizing Time Management for Drip-and-Ship Stroke Patients Qualifying for Endovascular Therapy-A Single-Network...

Area of Science:

• Neurology
• Emergency Medicine
• Healthcare Management

Background:

• Stroke patients requiring endovascular therapy (EVT) often undergo a drip-and-ship (DS) process.
• Delays in DS management can negatively impact patient outcomes.
• Identifying factors contributing to these delays is crucial for workflow optimization.

Purpose of the Study:

• To identify factors associated with delayed drip-and-ship (DS) management in stroke patients.
• To analyze process times and predictive factors for delays in DS transfers for EVT.

Main Methods:

• Retrospective study of 869 stroke patients transferred for EVT between 2016 and 2020.
• Analysis of emergency and hospital records to assess DS process times.
• Dichotomized admission periods (2016–2017 vs. 2018–2020) to evaluate process optimization impacts.

Main Results:

• Factors associated with delayed onset-to-EVT time included earlier admission periods (2016–2017), on-call status, longer transfer distances, and general anesthesia.
• Transfer mode, primary hospital type, large-vessel occlusion site, and intravenous thrombolysis also influenced DS management delays.
• Ambulance transfers were faster for <50 km, while helicopter transfers were faster for >71 km.

Conclusions:

• Assessment of DS processes and times is vital for identifying modifiable factors.
• Optimizing the drip-and-ship pathway can improve the time-critical workflow for stroke patients receiving EVT.