Stop Stroke© Acute Care Coordination Medical Application: A Brief Report on Postimplementation Performance at a Primary Stroke Center

• Published in: Journal of stroke and cerebrovascular diseases Vol. 25; no. 5; pp. 1275 - 1279
• Main Authors: Dickson, Robert L., MD, FAAEM, FACEP, FACEM, Sumathipala, Dineth, MBBS, Reeves, Jennifer, RN-MSN
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2016
• Subjects: Academic Medical Centers - organization & administration; acute care coordination; Cardiovascular; Delivery of Health Care, Integrated - organization & administration; emergency medical service; Emergency Medical Services - organization & administration; Fibrinolytic Agents - administration & dosage; Humans; Interdisciplinary Communication; medical application; Mobile Applications; Neurology; Patient Care Team - organization & administration; Program Evaluation; Quality Improvement - organization & administration; Quality Indicators, Health Care - organization & administration; Retrospective Studies; Stroke; Stroke - diagnosis; Stroke - drug therapy; Texas; therapy; Thrombolytic Therapy; Time Factors; time to therapy; Time-to-Treatment - organization & administration; tissue plasminogen activator; Tissue Plasminogen Activator - administration & dosage; Treatment Outcome; emergency medical service; Stroke; tissue plasminogen activator; time to therapy; therapy; medical application; acute care coordination
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2015.12.001

Background The objective of our study was to evaluate the effect of the Pulsara Stop Stroke© medical application on door-to-needle (DTN) time in patients presenting to our emergency department with acute ischemic stroke (AIS). The secondary objective was to evaluate the DTN performance of dedicated neurohospitalists versus private practice neurologists covering emergency department stroke call. Methods We conducted a retrospective cohort study of the Good Shepherd Health System stroke quality improvement dashboard for an 18-month period. The primary outcome was mean DTN time performance in cases with and without Stop Stroke© usage. Secondary outcome was mean DTN time between neurohospitalist and private neurologists with and without use of Stop Stroke©. Results During the study period, there were 85 stroke activations receiving tissue plasminogen activator (63 with Stop Stroke©, 22 without Stop Stroke©). In cases where the app was used, we observed a reduction in mean DTN time of 40 minutes (87-47 minutes), a 46% reduction. There was no significant difference in DTN time observed between the neurohospitalist and private neurologist performance independent of app usage. Mean DTN less than 60 minutes improved with app use from 18% to 85% with Stop Stroke©. Conclusions In patients arriving to our primary stroke center with AIS, use of Pulsara Stop Stroke© acute care coordination app decreased mean DTN time by 40 minutes, a significant 46% improvement in this metric and is consistent with other studies of the app. We further observed a 3.7× improvement in DTN less than 60 minutes with use of the app.