Abstract Details

Title Reducing Door to Telestroke Request Time in a Telestroke Network Reduces Door to Needle Time

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 162

Objective We aimed to evaluate if our educational activities and monthly data review affected door-to-telestroke request within 10 minutes of arrival, completion-of-video to needle within 1 minute and DTN within 60 minutes.

Background Prior studies have demonstrated the importance of measuring and monitoring door-to-needle time (DTN) and door-to-telestroke request, but there is limited data on educational efforts to reduce these metrics. We educated telestroke spokes on tips to reduce sub-events of DTN, developed a reference pocket card and reviewed metrics during monthly quality meetings with telestroke sites.

Design/Methods

Prospectively collected data was analyzed retrospectively from a telestroke network. �鶹��ýӳ�� of the spokes was completed between January 2019 and April 2019. We compared data for one year prior to education (January 2018 – December 2018) and one year after education (May 2019 – April 2020). Logistic regression analyses were performed to determine the odds of achieving a door-to-telestroke request within 10 minutes, DTN within 60 minutes and completion-of-video to needle within 1 minute in treated patients. We entered possible confounding variables (EMS arrival; NIHSS; posterior symptoms) in the first block followed by the pre/post education groups in the second block.

Results

Telestroke was requested 2574 times during the study (1338 pre-education; 1236 post-education). A trend towards more thrombolytic and thrombectomy treatments occurred after education compared to before education (14.6% vs. 12%), OR = 1.25 (95%CI 0.99 – 1.56), p=0.06. Door-to-telestroke request ≤ 10 minutes was more likely after education of the spokes, OR=2.15 (95%CI 1.27 – 3.66), p=0.005. DTN with 60 minutes was also more likely after education on telestroke sub-events OR = 1.83 (95%CI 1.04 – 3.20), p=0.035. Completion-of-video to needle with 1 minute was not significantly different after education, OR=0.76 (95%CI 0.37 – 1.59), p=0.47.

Conclusions �鶹��ýӳ�� and regular review of sub-events data reduced door-to-telestroke request and DTN time in our telestroke network

Authors/Disclosures
Chris Hackett, MA PRESENTER	Mr. Hackett has nothing to disclose.
Russell M. Cerejo, MD (Allegheny health Network)	Dr. Cerejo has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Ischemaview.
Konark Malhotra, MD (Allegheny Health Network)	Dr. Malhotra has nothing to disclose.
Sandeep S. Rana, MD, F�鶹��ýӳ�� (Allegheny Health Network)	Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSI. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pharmawrite. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for amylyx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.
Robert Fishman, MD (Butler Hospital)	Dr. Fishman has nothing to disclose.
David G. Wright, MD	Dr. Wright has nothing to disclose.
	No disclosure on file
Ashis H. Tayal, MD	Dr. Tayal has nothing to disclose.