Reducing the door-to-needle time for patients with acute ischemic stroke based on the quality improvement program of PDCA cycle

Abstract

Objective To investigate the role of reducing the door-to-needle time for patients with acute ischemic stroke based on the quality improvement program of PDCA cycle. Methods Consecutive patients with acute ischemic stroke admitted to hospital were registered prospectively from January 1, 2016 to September 30, 2016. Questionnaires and time tracking method were used to investigate the door-to-needle (DNT) and its influencing factors. PDCA cycle method was used to improve the stroke channel workflow and the changing trend of DNT was analyzed. Results A total of 71 patients with acute ischemic stroke were enrolled. After 3 PDCA cycles, DNT (median, interquartile range) from 100.0 min (65.5-127.0 min) reduced to58.0 min (45.5-80.0 min) (Z=11.689, P<0.001), the proportion of the patients with DNT ≤60 min increased from 19.05% to 60.00% (χ2=7.893, P=0.019). Conclusions The quality improvement program of PDCA cycle may effectively reduce the time of DNT in patients with acute ischemic stroke. Key words: Stroke; Brain Ischemia; Thrombolytic Therapy; Time-to-Treatment; Models, Organizational; Program Evaluation; Quality Improvement