Abstract Details

Title Effect on the Clinical Learning Environment after Expansion of the Thrombectomy Time Window

Topic Research Methodology, ��ɫ��, and History

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-020

Objective

We aimed to quantify the change in stroke alert volume after expanding the thrombectomy time window to 24 hours and assess the impact on the clinical learning environment.

Background

The DAWN trial advocated that clinical-core mismatch is a predictor of treatment effect independent of time to presentation. This led to expansion of the thrombectomy treatment window to 24 hours for ischemic stroke. This time window increase led to an increase in clinical volume and responsibilities of neurology residents and faculty.

Design/Methods Stroke alert pages were counted one year before and one year after this change in clinical practice. Each stroke alert page was reviewed for accuracy to ensure no duplication. The ACGME Resident Survey results from 2015-2016 were compared to the 2016-2017 and 2017-2018 results.

Results There were 899 stroke alerts during the 12 month time period prior to expansion of the thrombectomy window and 1,369 alerts the year following. This was a 34% increase in stroke alerts. The ACGME surveys were reviewed for duty hour compliance, ability for safe patient care transitions, and the cerebrovascular specialty specific education question.

Conclusions Changes to the thrombectomy time window increases stroke alert volume at one academic institution and can have an impact on the clinical learning environment. Understanding this impact is important to ensure that there is an appropriate balance for education, adequate clinical support for patient care, while monitoring and implementing programs to promote resident well-being.

Authors/Disclosures
Elizabeth M. Aradine, MD (Cleveland Clinic) PRESENTER	No disclosure on file
Scott Vota, DO, FAAN	No disclosure on file

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