Abstract Body: Introduction:
Telestroke has grown immensely across the U.S. in the past decade. While quantity has increased, quality remains variable. Emergency room (ER) physicians and stroke coordinators continue to experience pain points especially during hand-off to comprehensive stroke centers or when having to rely on teleradiologists for emergency interpretations for intravenous thrombolytic (IVT) or endovascular therapy (EVT) candidates. The Kaiser Permanente Southern California regional telestroke service is a vertically integrated model where the telestroke providers directly communicate with local neurointerventionalists and arrange the transfers. Assessment of the ER physicians’ impressions of the regional telestroke model will help identify key strengths and quality.
Methods:
An anonymous electronic survey was sent out to ER physicians in the Southern California Kaiser Permanente Locations in 2023-2024. 44 responded to the survey. Responses to questions were asked in a standard Likert Scale format.
Results:
80% strongly agreed that telestroke providers are crucial in meeting door-to-needle time (30min) by placing the IVT orders themselves. 82% agreed that the service is crucial in reducing transfer time by arranging EVT-capable stroke centers and giving sign-out on their own. 98% agreed that telestroke providers are interpreting non-contrast CT brain on their own to manage patients in the ED, and 91% agreed that they are interpreting CT Angiography of the Brain and Neck. 71% disagreed or strongly disagreed that the overall quality of acute care would have remained the same if they had to arrange and hand-off their own EVT transfers.
95% were satisfied or very satisfied in the overall quality of acute care by telestroke providers, and 91% were satisfied or very satisfied in the reduction of burden regarding the EVT transfer process.
Conclusion:
This survey following a 10-year regional telestroke model showed that ER physicians at the Kaiser Permanente Southern California were highly satisfied with the overall quality of the regional comprehensive telestroke service. The effective reduction of EVT transfer time and physicians’ burden in the process highlighted the telestroke service to be crucial in acute care.