Abstract NS9: When STK-OP-1 Surprises You... And So Does Your Large Vessel Occlusion Screening Tool!

Abstract

Background: STK-OP-1 is a relatively new measure that captures the transfer times for all patients transferring out of their presenting facility. The measure encompasses all reasons for transfer and is broken into sub-categories to highlight each patient population that requires care elsewhere. While it has been established that timely and rapid transfer for acute stroke intervention is essential and improves outcomes, the STK-OP-1 measure may be misleading without detailed case review. Purpose: What each facility does with the data from STK-OP-1 is dependent upon the patient population being reviewed and workflows that impact that population. The STK-OP-1d and STK-OP-1g measures focus on patients eligible for mechanical thrombectomy who need to transfer to a facility offering that service. In a center that does not offer thrombectomy, use of a large vessel occlusion (LVO) tool may not only increase the number of patients identified but also improve transfer times. Methods: STK-OP-1d and STK-OP-1g cases from two Primary Stroke Centers and their licensed freestanding emergency departments were reviewed following LVO tool implementation in 2019. Updates to use of the LVO tool in 2020 included early activation of the region’s rotor crew with positive LVO findings. Transfer times for thrombectomy eligible patients and volumes of identified LVO patients were compared from 2019 through 2022. Results: Review of transfer times reflected marked improvement in times for those patients meeting criteria for STK-OP-1d and STK-OP-1g. Following the 2020 workflow updates, the volumes of patients identified also improved. In 2019, there were 7 LVO patients with a median transfer time of 117 minutes. In 2020, there were 9 LVO patients with a median transfer time of 98 minutes. In 2021, there were 17 LVO patients and median transfer time was 93 minutes. For 2022, it is projected there will be 24 transfers with a median transfer time of 95 minutes. Conclusions: In conclusion, further differentiating the STK-OP-1 measure by treatment eligibility highlights those patients that require time sensitive interventions. Implementation of an LVO tool in centers with thrombectomy capabilities can improve the number of LVO patients identified and also support more expeditious transport.