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Shortening Door-to-Needle Time by Multidisciplinary Collaboration and Workflow Optimization During the COVID-19 Pandemic.
Chen, Yimin; Nguyen, Thanh N; Wellington, Jack; Mofatteh, Mohammad; Yao, Weiping; Hu, Zhaohui; Kuang, Qiuping; Wu, Weijuan; Wang, Xuejun; Sun, Yu; Ouyang, Kexun; Xu, Junmiao; Huang, Weiquan; Yang, Shuiquan.
  • Chen Y; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, No. 16, Guanghaidadaoxi, Sanshui District, Foshan, Guangdong Province 528100, China.
  • Nguyen TN; Thanh N. Nguyen Department of Neurology, Radiology, Boston University School of Medicine, Boston, MA, United States. Electronic address: thanh.nguyen@bmc.org.
  • Wellington J; School of Medicine, Cardiff University, Wales, United Kingdom. Electronic address: wellingtonj1@cardiff.ac.uk.
  • Mofatteh M; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom. Electronic address: mmofatteh01@qub.ac.uk.
  • Yao W; Dean Office, Foshan Sanshui District People's Hospital, Foshan, Guangdong Province, China.
  • Hu Z; Medical Department, Foshan Sanshui District People's Hospital, Foshan, Guangdong Province, China.
  • Kuang Q; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, No. 16, Guanghaidadaoxi, Sanshui District, Foshan, Guangdong Province 528100, China.
  • Wu W; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, No. 16, Guanghaidadaoxi, Sanshui District, Foshan, Guangdong Province 528100, China.
  • Wang X; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, No. 16, Guanghaidadaoxi, Sanshui District, Foshan, Guangdong Province 528100, China.
  • Sun Y; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, No. 16, Guanghaidadaoxi, Sanshui District, Foshan, Guangdong Province 528100, China.
  • Ouyang K; Department of Radiology, Foshan Sanshui District People's Hospital, Foshan, Guangdong Province, China.
  • Xu J; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, No. 16, Guanghaidadaoxi, Sanshui District, Foshan, Guangdong Province 528100, China.
  • Huang W; Medical Intern, Foshan Sanshui District People's Hospital, Foshan, Guangdong Province, China; School of Medicine, Shaoguan University, Shaoguan, Guangdong Province, China.
  • Yang S; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital, No. 16, Guanghaidadaoxi, Sanshui District, Foshan, Guangdong Province 528100, China. Electronic address: yangshuiquan1969@126.com.
J Stroke Cerebrovasc Dis ; 31(1): 106179, 2022 Jan.
Article Dans Anglais | MEDLINE | ID: covidwho-1525870
ABSTRACT

OBJECTIVES:

This study aims to evaluate shortening door-to-needle time of intravenous recombinant tissue plasminogen activator of acute ischemic stroke patients by multidisciplinary collaboration and workflow optimization based on our hospital resources. MATERIALS AND

METHODS:

We included patients undergoing thrombolysis with intravenous recombinant tissue plasminogen activator from January 1, 2018, to September 30, 2020. Patients were divided into pre- (January 1, 2018, to December 31, 2019) and post-intervention groups (January 1, 2020, to September 31, 2020). We conducted multi-department collaboration and process optimization by implementing 16 different measures in prehospital, in-hospital, and post-acute feedback stages for acute ischemic stroke patients treated with intravenous thrombolysis. A comparison of outcomes between both groups was analyzed.

RESULTS:

Two hundred and sixty-three patients received intravenous recombinant tissue plasminogen activator in our hospital during the study period, with 128 and 135 patients receiving treatment in the pre-intervention and post-intervention groups, respectively. The median (interquartile range) door-to-needle time decreased significantly from 57.0 (45.3-77.8) min to 37.0 (29.0-49.0) min. Door-to-needle time was shortened to 32 min in the post-intervention period in the 3rd quarter of 2020. The door-to-needle times at the metrics of ≤ 30 min, ≤ 45 min, ≤ 60 min improved considerably, and the DNT> 60 min metric exhibited a significant reduction.

CONCLUSIONS:

A multidisciplinary collaboration and continuous process optimization can result in overall shortened door-to-needle despite the challenges incurred by the COVID-19 pandemic.
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Mots clés

Texte intégral: Disponible Collection: Bases de données internationales Base de données: MEDLINE Sujet Principal: Équipe soignante / Traitement thrombolytique / Encéphalopathie ischémique / Activateur tissulaire du plasminogène / Comportement coopératif / Accident vasculaire cérébral ischémique / COVID-19 Type d'étude: Études expérimentales / Étude pronostique / Essai contrôlé randomisé Les sujets: Covid long Limites du sujet: Femelle / Humains / Mâle langue: Anglais Revue: J Stroke Cerebrovasc Dis Thème du journal: Maladies vasculaires / Cerveau Année: 2022 Type de document: Article Pays d'affiliation: J.jstrokecerebrovasdis.2021.106179

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Texte intégral: Disponible Collection: Bases de données internationales Base de données: MEDLINE Sujet Principal: Équipe soignante / Traitement thrombolytique / Encéphalopathie ischémique / Activateur tissulaire du plasminogène / Comportement coopératif / Accident vasculaire cérébral ischémique / COVID-19 Type d'étude: Études expérimentales / Étude pronostique / Essai contrôlé randomisé Les sujets: Covid long Limites du sujet: Femelle / Humains / Mâle langue: Anglais Revue: J Stroke Cerebrovasc Dis Thème du journal: Maladies vasculaires / Cerveau Année: 2022 Type de document: Article Pays d'affiliation: J.jstrokecerebrovasdis.2021.106179