The ‘pit-crew’ model for improving door-to-needle times in endovascular stroke therapy: a Six-Sigma project
| العنوان: | The ‘pit-crew’ model for improving door-to-needle times in endovascular stroke therapy: a Six-Sigma project |
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| المؤلفون: | Ansaar T Rai, Gerald R. Hobbs, Jeffrey S Carpenter, Matthew S. Smith, Abdul R Tarabishy, SoHyun Boo |
| المصدر: | Journal of Neurointerventional Surgery |
| بيانات النشر: | BMJ, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Male, Emergency Medical Services, Standards, medicine.medical_specialty, Time Factors, Crew, Computed tomography, 030204 cardiovascular system & hematology, Bioinformatics, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Care pathway, medicine, Humans, Thrombolytic Therapy, Tertiary level, Stroke, Aged, Ischemic Stroke, Aged, 80 and over, Academic Medical Centers, medicine.diagnostic_test, business.industry, Endovascular Procedures, General Medicine, Middle Aged, medicine.disease, Stroke treatment, Door to needle time, Needles, Tissue Plasminogen Activator, Ischemic stroke, Emergency medicine, Female, Surgery, Neurology (clinical), Tomography, X-Ray Computed, business, 030217 neurology & neurosurgery |
| الوصف: | BackgroundDelays in delivering endovascular stroke therapy adversely affect outcomes. Time-sensitive treatments such as stroke interventions benefit from methodically developed protocols. Clearly defined roles in these protocols allow for parallel processing of tasks, resulting in consistent delivery of care.ObjectiveTo present the outcomes of a quality-improvement (QI) process directed at reducing stroke treatment times in a tertiary level academic medical center.MethodsA Six-Sigma-based QI process was developed over a 3-month period. After an initial analysis, procedures were implemented and fine-tuned to identify and address rate-limiting steps in the endovascular care pathway. Prospectively recorded treatment times were then compared in two groups of patients who were treated ‘before’ (n=64) or ‘after’ (n=30) the QI process. Three time intervals were measured: emergency room (ER) to arrival for CT scan (ER–CT), CT scan to interventional laboratory arrival (CT–Lab), and interventional laboratory arrival to groin puncture (Lab–puncture).ResultsThe ER–CT time was 40 (±29) min in the ‘before’ and 26 (±15) min in the ‘after’ group (p=0.008). The CT–Lab time was 87 (±47) min in the ‘before’ and 51 (±33) min in the ‘after’ group (p=0.0002). The Lab–puncture time was 24 (±11) min in the ‘before’ and 15 (±4) min in the ‘after’ group (pConclusionsA protocol-driven process can significantly improve efficiency of care in time-sensitive stroke interventions. |
| تدمد: | 1759-8486 1759-8478 |
| DOI: | 10.1136/neurintsurg-2015-012219 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8071f073caa01b4f4b685fd170859f7a https://doi.org/10.1136/neurintsurg-2015-012219 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8071f073caa01b4f4b685fd170859f7a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17598486 17598478 |
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| DOI: | 10.1136/neurintsurg-2015-012219 |