and 6 other(s)
Background Time to revascularization is critical in improving outcomes in stroke patients. We hypothesized that: a mobile app can help reduce door to needle time by taking the stroke team through the clinical pathway along with real time notifications. Methods Consecutive patients presenting to the Emergency Department between April 2017 - March 2018 with acute stroke were entered in a mobile app with patient parameters, timer, NIH stroke scale (NIHSS), thrombolysis checklist and tPA dose calculator. The app also enabled team synchronization by notifying all members and of the patient movement in real time, along with sharing of images. Door to needle time (DNT) captured from the app was entered into a spreadsheet and compared to previous values from our center. Findings 62 patients where thrombolysed while using the mobile app. The mean DNT was 45 min with 89% being thrombolysed within 60mins.These patients were compared with 100 consecutive patients who were thrombolysed in the months prior to April 2017, where the mean DNT was 57min, with 67% thrombolysed within 60mins. A mean DNT decrease of 12 minutes was seen with 1.3x increase in DNT < 60 min. This difference was statistically significant (p=0.0104, unpaired t test). The causes of delay were identified and included delays in patient shifting and imaging. Result and Conclusion We have been able to demonstrate significant improvement in door to needle time by using a mobile app as a tool to improve team performance, and identify causes of delay.
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