DOI: 10.1161/str.55.suppl_1.tp54 ISSN: 0039-2499

Abstract TP54: Ready to Ride

Laura A Stein, Karlie Scavicchio, Melissa Spahr, Colin Hoey, Michele Sellers, Aaron Rothstein, Christopher Ware
  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Neurology (clinical)

Background: For stroke patients initially presenting to a primary stroke center with large vessel occlusions (LVO), treatment involves evaluation and subsequent transfer for thrombectomy. Our institution has utilized many of the AHA best practice strategies for improving door-in-door-out (DIDO), though targeting efficiency of the hand-off to the transporting team was not previously targeted.

Purpose: This process sought to streamline hand-offs to the transporting team to improve overall DIDO times at our primary stroke center, specifically through decreasing the average transport team arrival to patient departure time.

Methods: We identified multiple opportunities for intervention: improved documentation of Emergency Department departure time, standardized communication with transport team, and need for consistent path to helipad. A standard method of communicating transport team estimated arrival was established to ensure readiness of emergency department staff and patient for transport to helipad. A structured report including the required paperwork was created for all transfers between the emergency department providers and transport team. Lastly, a consistent path to the helipad itself was identified. A Mann Whitney Test was used to compare the means of door in to transport departure and transport arrival to transport departure. Transport departure was used as the standard for door out.

Results: Mean for door to transport departure pre intervention was 126.47 (STD of 33.13). Post-intervention was 126. 43 with STD of 56.62. This was not significant (p=0.76). Mean for transport arrival to transport departure prior to intervention was 26.72 minutes (STD of 8.44) and post intervention was 19.86 (STD of 16.65). This was significant (p=0.01).

Conclusions: Standardizing hand-offs and improving transport efficiency and communication are feasible interventions in overall efforts to improve care delivery and efficiency. Early data suggests these interventions decrease time between transport arrival and door out. Further work is necessary to assess impact on DIDO.

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