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IMPLEMENTATION OF MULTIFACETED QUALITY INITIATIVES WITH A TELEMEDICAL PRENOTIFICATION SYSTEM IN A RURAL AREA IN HYPERACUTE STROKE CARE

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ESOC-2019

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Abstract

Abstract topic: Hyperacute management- excluding clinical trial results Abstract title: Implementation of multifaceted quality initiatives with a telemedical prenotification system in a rural area in hyperacute stroke care Abstract text: Background: Quality improvement collaboratives (QIC) has become an integral and permanent component of hyperacute stroke care and strives to bridge the gap between current practice and ideal practice [1]. In addition to current guideline and literature best practice recommendations [2], we stepwise developed and integrated an innovative hyperacute stroke management system into routine care. Material and Methods: Our quality programme consists of 16-item multifaceted targeted implementation strategies. Next to the Helsinki model [3], our hyperacute stroke management system consist of digital on-scene assessment with the 4-item stroke scale, telemedical prenotification of predefined elements (including still picture and video of prehospital stroke assessment), single call activation of stroke team, integration of prehospital data into the hospital information system, continuous monitoring of cross-sectoral quality indicators, annually feedback within a workshop, and a community-based education campaign. Results: Since the start of our QIC in 2005 till 2018 we observed a steady decrease of Door-to-Needle (from 61 min to 22 min) and Door-to-CT time (from 33 min to 8 min), as well as an increase of thrombolysis rate (from 7% to 31%). Video-transmission between ambulance and stroke unit further led to an increased precision of decisions while the patient is en route regarding stroke patient assessment, management and transport in real clinical routine care. Conclusion: The implementation of an innovative telemedical prenotification system in a German rural area prompt the elimination of specific barriers to the initiation and delivery of stroke thrombolysis.

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© Copyright 2020 Morressier GmbH.
All rights reserved.