Abstract WMP19: When Minutes Count: Addition Of Stroke Transfer Coordinator

Abstract

The treatment of hyper acute ischemic stroke is time critical, requiring a coordinated team response. It is common among primary and comprehensive stroke centers to have a “stroke alert” process, activating physicians, laboratory, radiology, and nursing support. In our center, the stroke alert included activation of a stroke program coordinator during day hours to assist with data gathering and time tracking. A clinical nurse expert would attend stroke alerts as able to on nightshift. At times, there were gaps when no personnel were available, and data was backtracked. In 2021, the use of Viz.AI was implemented. The Viz app allows streamlined communication amongst the treatment team (MD, ED Charge, Bed Capacity, etc.). Information including COVID status, time of Contrast given, imaging studies, and family contact information are exchanged prior to the patient’s arrival. Six Stroke Transfer Coordinators (STC) were hired, whose primary focus was attending stroke alerts, monitoring CT scans through the Viz app, and facilitating the transfer of patients with Large Vessel Occlusion (LVO) for thrombectomy treatment. Methods: This is a single center retrospective cohort study. Basic demographic data, presence of LVO, time of last known well, time of imaging, time of transfer acceptance, NIHSS, and thrombolysis prior to transfer were recorded. Door-in-door out, door-to-angiogram, and door-to-groin puncture times were also collected. We compared and analyzed data from 12 months prior to implementation of the STC (August 2020-July 2021) to the 12 months post-implementation (August 2021 to July 2022). Results: Total number of Stroke Alerts (SA) in the pre-STC time period was 1479, with 136 thrombectomy alert. Post-TSC the total number of SA was 1306, with 179 thrombectomy alerts. The mean door-to-intervention time pre-STC was 24 minutes (median=25 minutes). Post implementation of the STC, the mean door-to-intervention time was 17 minutes (median= 12 minutes). Conclusions: STC’s improved the door-to-intervention time by mean of 7 minutes (median= 13 minutes). When every minute counts in re-establishing brain perfusion, this improvement may lead to better patient outcomes. Further study is necessary.