Time is a critical factor in stroke treatment. Reducing treatment delays by improving workflows can significantly improve treatment efficacy. In 2020, Glens Falls Hospital, a primary stroke center in a community hospital setting, challenged itself to improve the quality and efficiency of its stroke care.
The hospital began by expanding its “door-to-treatment” quality improvement focus to include post-treatment workflow. This ensures that patients move efficiently to the most appropriate level of care through improved patient hand-offs and optimized nursing resources in the emergency department and intensive care units.
Additionally, an interdisciplinary workgroup designed and implemented a “Code tPA” process, which aims to reduce the time to transfer ischemic stroke patients out of the ED to within 45 minutes of the start of tPA medication. At its core, Code tPA is an integrated communication tool that ensures care teams receive timely notification of role-specific tasks for the efficient transfer of patients for inpatient monitoring. In addition, a focused workgroup performs ongoing clinical reviews using a custom dashboard for tracking and trending.
As a result of Code tPA, the hospital achieved a 40-minute median transfer time from ED arrival to start of tPA medication by the first quarter of 2021.
For more information, contact Cassandra Moore, MS, RN, CNE, CCRN-K, SCRN, service line administrator, Neurology and Stroke Program, at email@example.com or 518.926.3413.