Shortening Door-to-Needle Time by Multidisciplinary Collaboration and Workflow Optimization During the COVID-19 Pandemic.
J Stroke Cerebrovasc Dis
; 31(1): 106179, 2022 Jan.
Artigo
em Inglês
| 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 ANDMETHODS:
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.Palavras-chave
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
/
Terapia Trombolítica
/
Isquemia Encefálica
/
Ativador de Plasminogênio Tecidual
/
Comportamento Cooperativo
/
AVC Isquêmico
/
COVID-19
Tipo de estudo:
Estudo experimental
/
Estudo prognóstico
/
Ensaios controlados aleatorizados
Tópicos:
Covid persistente
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
J Stroke Cerebrovasc Dis
Assunto da revista:
Angiologia
/
Cérebro
Ano de publicação:
2022
Tipo de documento:
Artigo
País de afiliação:
J.jstrokecerebrovasdis.2021.106179
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