Abstract Details

Title The?Impact of?a 24-hour?Thrombectomy?Window on Resident ��ɫ��

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

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

Poster/Presentation
Number 4-021

Objective NA

Background The Diffusion-Weighted Imaging or Computerized Tomography Perfusion Assessment with Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention with Trevo (DAWN) trial advocated that clinical-core mismatch is a predictor of treatment effect independent of time to presentation. This led to expansion of the stroke treatment window to 24 hours at many centers. Our program was not a DAWN site and had been considering patients for thrombectomy within the 24-hour window since July 2016. This study aims to discern the impact of stroke-window expansion on resident education.

Design/Methods The volume of stroke alerts pre- and post- thrombectomy window expansion (2,285 total alerts) was analyzed via the paging system. Responses from 36 Accreditation Council for Graduate Medical ��ɫ�� resident surveys from before and after the window adjustment were studied to determine impact on the learning environment.

Results There was a 47% increase in stroke alerts (925 to 1,360) the year following window expansion. Residents’ view of their educational time decreased significantly. The number who believed they had an “appropriate balance for education” decreased by 34% from 2016 to 2017. The number who felt “education was not compromised” by service obligations decreased 26%. Following staff expansion in 2018, the number who believed education wasn’t compromised rose 47%, while those who agreed there was an appropriate balance decreased another 5%.

Conclusions Increasing the time window for mechanical intervention in stroke to 24 hours has implications on the resident workforce at an academic medical center. Hiring additional personnel can help alleviate this burden, but further analysis is needed to ensure a clinical learning environment that appropriately balances service and education.

Authors/Disclosures
Rachel Aubert, DO (UT Southwestern Medical Center) PRESENTER	Dr. Aubert has nothing to disclose.
Elizabeth M. Aradine, MD (Cleveland Clinic)	No disclosure on file
Juan Pablo Pauta Martinez, MD	Dr. Pauta Martinez has nothing to disclose.
Prachi Mehndiratta, MD	Dr. Mehndiratta has nothing to disclose.
Scott Vota, DO, FAAN	No disclosure on file

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