Simulation-based team training improves door-to-needle time for intravenous thrombolysis

Area of Science:

• Neurology
• Medical Education
• Healthcare Logistics

Background:

• Clinical need exists for reduced door-to-needle time (DNT) in intravenous thrombolysis for stroke.
• Effective training methods for improving stroke care logistics are currently lacking.
• Simulation training has shown benefits in teamwork and logistics across various fields.

Purpose of the Study:

• To evaluate the efficiency of a simulation training program on DNT for stroke care.
• To assess if simulation training improves stroke care logistics compared to non-participating centers.

Main Methods:

• A simulation training program was implemented in selected stroke centers in the Czech Republic.
• Door-to-needle times (DNT) from participating centers were compared with non-participating centers.
• Patient data were prospectively collected from the Safe Implementation of Treatments in Stroke Registry (2015 and 2018).

Main Results:

• Simulation training was associated with a significant reduction in DNT by 30 minutes in 2018 compared to 2015.
• Stroke centers with simulation training showed a greater DNT improvement than those without.
• A trend towards reduced parenchymal hemorrhage was observed in centers with simulation training.

Conclusions:

• Simulation training proved feasible as a nationwide program for improving stroke care.
• The study demonstrated an association between simulation training and improved DNT.
• Further research is recommended to confirm the causal relationship between simulation and improved DNT.