Abstract Body: Introduction:

Acute ischemic stroke (AIS) requires immediate identification and efficient treatment. Particularly, Large Vessel Occlusions (LVOs) may necessitate thrombectomy to restore brain blood flow. Rapid treatment times from symptom onset and hospital arrival to revascularization are critical for improved outcomes. When a thrombectomy candidate is identified, swift transport to our Neurological Interventional Radiology (NIR) Cath Lab (CL) is necessary. The introduction of a new hospital building in 2019 required new transportation workflows, which were updated in 2022 due to concerns about delayed transport times. As a Comprehensive Stroke Center (CSC), we evaluate each thrombectomy case and track key metrics as part of our commitment to provide swift, safe treatment. These metrics are part of The Joint Commission's Comprehensive Stroke core measures.

Method:

Organizational improvement projects use an A3 structured approach. A workgroup comprising of stakeholders from CSC’s Stroke Department, ED, and NIR CL, focused on analyzing current metrics and gaps, leading to revising the transportation workflow. Focus areas included turnover-induced knowledge gaps, limited preparation time, miscommunication, and heavy workloads hindering prompt communication. These resulted in delayed transport to CL. To rectify this, the team improved communication and clarified roles via a novel workflow (Fig. 1). Now, the CL RN coordinates with the ED RN to organize patient transport. The transition towards task-specific roles reduced educational requirements and increased efficiency. This framework went live in October 2022.

Results:
See image 3.

Conclusion:

With the successful implementation of the new workflow, thrombectomy patients saw 20-21% treatment time improvements (Fig. 2). The CSC continues to monitor these metrics for further improvement.

Standardizing workflows, with a focus on improved communication, can decrease LVO patient’s arrival-to-treatment times and is applicable to other acute care facilities.