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Abstract Details

Door to stroke alert timing quality improvement project
Cerebrovascular Disease and Interventional Neurology
P3 - Poster Session 3 (5:30 PM-6:30 PM)
3-051

To reduce the number of stroke alerts with door to alert time (DTAT) of greater than ten minutes.
In the United States, nearly 800,000 people per year have a stroke. 87% of these strokes are ischemic, and the mainstay of treatment is re-vascularization. Patient outcomes are optimized when these treatments are administered early.  One significant barrier to early revascularization is recognition of a patient potentially having a stroke.

This project was completed through a multicenter stroke network that spans eight counties in Pennsylvania where all hospitals are primary or comprehensive stroke centers. 500 stroke alerts with greater than ten minutes DTAT, from January 2016 to December 2016, were retrospectively analyzed to determine commonalties. In an attempt to decrease DTAT, flyers highlighting common stoke symptoms were posted, and lectures for ED and EMS staff were given. After six months of implementation, 906 stroke alerts, from July 2017 to June 2018, were evaluated for greater than ten minutes DTAT.
In 2016, 201 out of 500 stroke alerts (40.20%) had greater than ten minutes DTAT with 36.3% of patients having a final diagnosis of stroke or CVA. EMS did not document a stroke assessment on 80.7% of patients. A total of 20 (10.2%) of patients received treatment with IV alteplase. After strategy implementation, strokes with greater than ten minutes DTAT decreased to 25.60% from 40.20% despite an overall two times increase of strokes alerts.
Low cost and simple methods such as flyers and lectures can significantly reduce the door to stroke alert time. 
Authors/Disclosures
Joshua Luster, MD
PRESENTER 		Dr. Luster has nothing to disclose.
Dhanalakshmi Thiyagarajan (St. Luke'S Hospital) No disclosure on file
Daniel J. Ackerman, MD, FAAN (Saint Luke'S University Hospital) Dr. Ackerman has nothing to disclose.