| Learning Objective #1: Identify practice barriers to forming a successful interdisciplinary team | |||
| Learning Objective #2: Analyze how daily clinical practice can be linked to evidenced-based practices |
Background: After a decade of thrombolytic use in stroke and treating less than 1% of patients, it was apparent that a process change was needed. We created a Stroke Rapid Response Team (RRT) to build a systematic approach to stroke assessment, diagnosis and intervention. Method: The RRT was developed utilizing recommendations from the American Stroke Association and a review of the literature published on stroke treatment. Using a Trauma Center Model, we built an Acute Stroke Center by establishing clear internal departmental communications, standardized treatment protocols and EMS/community education. The team composed of select staff from the Departments of Neurology, Emergency Medicine and Nursing dissected all processes related to stroke care. Door to Needle time (DTN), door to CT scan (DTCT) and mean time to physician evaluation was collected and analyzed. Results: During 2000-2003, 47 patients were treated, age ranging from 39-84, with NIHSS mean of 13. Mean(DTN)time was 90 minutes with eight patients receiving therapy in less than 60 minutes. Ninety-day outcome data was tracked on all patients receiving thrombolytic therapy, with 77% having slight to no disability (Rankin 0-2) and 83% of patients having Barthel scores greater than 80. Conclusions: Interdisciplinary collaboration and communication is critical to the success of this project. Monthly team meetings with assigned tasks that have follow-up, provide team members with ability to see complications and increased health care team satisfaction with stroke program. Interdisciplinary coordination of care has allowed us to increase our ability to safely offer thrombolytic therapy in a community hospital with good patient outcomes.
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