Abstract WP284: Telestroke Coverage Improves Stroke Care In The Urban Hospital Setting

Abstract

Introduction: Telestroke consultation has been promoted as a way to improve stroke care in the remote hospital setting where neurology coverage is not available. The question remains if there is a benefit of telestroke consultation in the urban hospital setting where neurology coverage already exists. Hypothesis: We hypothesize that the use of telestroke consultation will improve patient treatment times in the urban hospital setting while maintaining patient satisfaction. Methods: In May 2011 our hospital, a Joint Commission certified Primary Stroke Center hospital located in a metropolitan area implemented telestroke coverage to aid with the rapid evaluation and treatment of patients with acute stroke. Telestroke coverage did not replace 24 hour neurologist call coverage but assisted in the acute evaluation when a neurologist was not present at the bedside. We performed a retrospective data comparison on stroke care for one year before and one year after implementing telestroke coverage. A total of 632 stroke alerts were reviewed for the following: percentage of patients treated with intravenous thrombolytics, Door-to-CT scan time, Door-to-treatment time, patient satisfaction. Results: There was a 14% increase in stroke alerts following telestroke implementation. Treatment rates were similar, 10.8% verses 11.3% with telestroke. There was a decrease from 83 minutes to 66 minutes for door-to-treatment time with telestroke. Treatment times were identical for patients treated with telestroke versus bedside neurologist during the first year of telestroke coverage. Patient satisfaction results remained high with telestroke. Conclusions: In conclusion telestroke consultation can be an effective tool for improving patient treatment times while maintaining high patient satisfaction in the urban hospital setting.