The Smart Stroke Fast Track: A Digital Workflow Innovation to Reduce Door-to-Needle Time in Acute Ischemic Stroke

Area of Science:

• Neurology
• Health Informatics
• Healthcare Management

Background:

• Timely thrombolysis is critical for acute ischemic stroke (AIS) treatment.
• Delays in AIS care are often caused by communication and workflow inefficiencies.
• Digital platforms can potentially optimize acute stroke care pathways.

Purpose of the Study:

• To evaluate the impact of the Smart Stroke Fast Track (SSFT) digital platform on reducing door-to-needle (DTN) time.
• To assess the SSFT's effect on overall workflow efficiency in acute ischemic stroke management.
• To determine the scalability of the SSFT for stroke systems, particularly in resource-limited settings.

Main Methods:

• A pre-post implementation study design was employed at Naresuan University Hospital.
• The SSFT platform, an in-hospital digital application, was implemented to integrate triage, team alerts, rt-PA calculation, and patient tracking.
• Data from 40 acute ischemic stroke patients (20 pre-SSFT, 20 post-SSFT) were analyzed, comparing median DTN times and other workflow metrics.

Main Results:

• Median door-to-needle time significantly decreased from 57.5 minutes to 41.5 minutes (p <0.001).
• The proportion of patients treated within 60 minutes increased from 60% to 100% (p=0.002).
• Significant reductions were observed across key workflow time intervals, with no adverse impact on safety outcomes.

Conclusions:

• The SSFT digital platform effectively reduces treatment delays in acute ischemic stroke care.
• Implementation of SSFT enhances workflow coordination and efficiency for stroke management.
• The SSFT presents a scalable digital solution for improving stroke systems, especially in resource-constrained environments.