Treating Stroke Patients
The Problem
Time is one of the most important factors when treating stroke
patients and, in some cases, administering clot-busting medication can
limit brain damage and reduce the likelihood of disability, yet working
out whether or not a patient is suitable to receive particular treatment
types can be complicated and time-consuming.
The Solution
The Peninsula Collaboration for Health Operational Research and
Development (PenCHORD) has been working with the NHS to create a
detailed working model of the path that patients take when they have a
stroke, replicating the journey from onset of the condition right
through to the point of treatment.
They include the roles of paramedics, nurses, emergency department
clinicians, the acute stroke team and the radiology department, and then
use this model to test how changes in the system might affect the
delivery of care. With several new initiatives established, the team
implemented their findings at the Royal Devon & Exeter Hospital
Trust.
The Value
Within 18 months of implementation, the number of patients with acute
ischemic stroke receiving medication more than doubled, increasing from
4.7% to 11.5%. The average time patients had to wait for this treatment
also dropped substantially, coming down from 58 minutes to 33.
Four years into the new processes, treatment rates have increased
threefold, up to 14%. For over 600 people admitted with acute stroke
every year, the Royal Devon & Exeter Hospital is matching or beating
the performance of the big urban stroke centres elsewhere in the UK and
the world.