Abstract 169: Rural Hospitals in Telestroke: How Effective are On-Site Mock Drills and Community Education on Stroke Awareness?

Abstract

Background: Mock drills of stroke triage care is an essential training component of most telestroke programs. Another potential component for telestroke programs is community stroke awareness education. While stroke-mocks improve the timeliness and care in rural spoke emergency departments (ED), community stroke awareness education may also improve treatment. Mocks and community education information was evaluated in the Arkansas Stroke Assistance through Virtual Emergency Support (AR SAVES) telestroke program. Correlations were made with mean Door to ED physician (D2MD) time and door-to-needle (D2N) Alteplase time and administration numbers (#Alteplase) and consult numbers (#Consults). Hypothesis: Total number of mocks (#Mocks) and community education events (#Community-events) will independently increase #Consults and #Alteplase, and improve the D2MD and D2N time. Methods: We retrospectively reviewed 2017 spoke hospital data from AR SAVES, the largest statewide telestroke program. The total number of #Mocks, #Community-Events was comparatively analyzed using regression analysis for D2MD, D2N, #Consults and #Alteplase. Results: Data from 51 spoke sites and 1,002 consults, indicated #Mocks were positively correlated to the D2MD time (R=0.31; p=0.03) and the #Alteplase (R=0.28; p=0.04); however, increasing the #Mock sessions did not influence the D2N time or the #Consults (p=NS). Community-Events were significantly associated with #Consults (R=0.48; p=0.0004) and #Alteplase (R=0.47; p=0.0006); however not to D2MD time or D2N time (p=NS). Conclusions: Mocks and Community stroke awareness education played crucial roles in the AR SAVES program improving #Consults and #Alteplase administrations. Both education components are warranted for telestroke programs.