Simulation-Based Quality Improvement and Training to Improve Door to Puncture Time for Mechanical Thrombectomy

Area of Science:

• Neurology
• Interventional Radiology
• Healthcare Quality Improvement

Background:

• Mechanical Thrombectomy (MT) is the standard treatment for acute ischemic stroke due to large vessel occlusion.
• Faster reperfusion is directly linked to better patient outcomes.
• Optimizing the patient journey is crucial for improving treatment efficacy.

Purpose of the Study:

• To reduce the door-to-puncture (DTP) time for MT.
• To improve the hyperacute care pathway for stroke patients.
• To assess the impact of simulation-based training on DTP time.

Main Methods:

• A single-center prospective study utilizing two multidisciplinary simulation exercises.
• Data collected from MT patients 6 months pre- and post-simulation.
• Paired t-test used for statistical comparison of DTP times.

Main Results:

• Mean DTP time decreased from 132.38 minutes pre-simulation to 104.52 minutes post-simulation for direct-to-hospital arrivals.
• A statistically significant reduction of 27.86 minutes in DTP time was achieved (p=0.02).
• No significant DTP time reduction was observed for inter-hospital transfer patients.

Conclusions:

• Simulation-based training is an effective method for reducing DTP time in MT.
• Regular staff training can optimize the stroke care pathway.
• This quality improvement strategy has the potential to improve patient outcomes.