{"id":"ed5b1ed0-59f8-4f11-ac30-0b360f7ed809","slug":"implementation-of-an-institution-wide-acute-stroke-algorithm-improving-stroke-quality-metrics","title":"Implementation of an institution-wide acute stroke algorithm: Improving stroke quality metrics","authors":["Scott L. Zuckerman","Jordan A. Magarik","Kiersten B. Espaillat","Nishant Ganesh Kumar","Ritwik Bhatia","Michael C. Dewan","Peter J. Morone","Lisa D. Hermann","Anne E. O’Duffy","Derek A. Riebau","Howard S. Kirshner","J. Mocco"],"abstract":"Background: In May 2012, an updated stroke algorithm was implemented at Vanderbilt University Medical Center. The current study objectives were to: (1) describe the process of implementing a new stroke algorithm and (2) compare pre- and post-algorithm quality improvement (QI) metrics, specificaly door to computed tomography time (DTCT), door to neurology time (DTN), and door to tPA administration time (DTT). Methods: Our institutional stroke algorithm underwent extensive revision, with a focus on removing variability, streamlining care, and improving time delays. The updated stroke algorithm was implemented in May 2012. Three primary stroke QI metrics were evaluated over four separate 3-month time points, one pre- and three post-algorithm periods. Results: The following data points improved after algorithm implementation: average DTCT decreased from 39.9 to 12.8 min (P P ≤ 0.001), and average DTT decreased from 62.5 to 43.5 min (P = 0.17). Conclusion: A new stroke protocol that prioritized neurointervention at our institution resulted in significant lowering in the DTCT and DTN, with a nonsignificant improvement in DTT.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/ed5b1ed0-59f8-4f11-ac30-0b360f7ed809/featured/hero-1782420893051.png","publishDate":"2016-12-21T00:00:00.000Z","doi":"10.4103/2152-7806.196366","categories":["Neurovascular","Original Article"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2017/01/8239/SNI-7-1041.pdf"}