Abstract TP259: Mission: Lifeline Stroke Education Campaign Drives Systems of Care Improvement in North Dakota

Abstract

Introduction: The AHA Mission: Lifeline Stroke program is a 3-year initiative in North Dakota which aims to improve statewide stroke systems of care. Due to complexities in recognizing and treating stroke patients, effectively educating prehospital and hospital health care providers on guideline-based assessments and treatment methods was identified as an interventional opportunity. Purpose: The purpose of the education campaign was to increase early recognition of stroke symptoms and expand application of guideline-based triage and treatment protocols thereby improving early recognition, treatment times and outcomes. Methods: The planning group considered individual learning style preferences by using the Visual, Auditory, Read/Write, and Kinesthetic (VARK) model which divides learners into these four categories. Beginning in January 2017, the following education offerings were deployed to address each style: in person lectures, conferences, workshops, stroke simulation trainings, online courses, webinars and a stroke certification course. Topics included: stroke symptom screening, severity scoring, LVO criteria, transport protocols, statewide stroke treatment guidelines and IV alteplase administration. Systems improvement data was correlated from the GWTG-Stroke registry in which all 6 ND tertiary hospitals and 32 of 36 critical access hospitals participate. Results: In the ND critical access hospital cohort the percentage of stroke patients who received brain imaging within 25 minutes of arrival increased from 57.1% in 2016 to 72% in 2018, and those who arrived at the hospital within 2 hours of LKW and received IV alteplase within 3 hours increased from 56.0% in 2016 to 64.3% in 2018. While in the all ND hospital cohort the percentage of acute ischemic stroke patients receiving IV alteplase within 60 minutes of arrival increased from 66.2% in 2016 to 78.2% in 2018. Conclusions: A multifaceted stroke education campaign can be an effective way to improve statewide stroke triage and treatment times. Continuing educational efforts are needed to maintain these gains and elicit further advancements. Additional studies are needed to determine if an improvement in triage and treatment times corresponds with reduced mortality and morbidity.