2.50
Hdl Handle:
http://hdl.handle.net/10755/344143
Category:
Abstract
Type:
Poster
Title:
STROKE*45
Author(s):
Hudelson, Kadi
Lead Author STTI Affiliation:
Non-member
Author Details:
Kadi Hudelson, RN, hudelson.kadi@mhsil.com
Abstract:
Evidence-based Practice Abstract Purpose: Stroke is a major cause of disability and death. Therefore, time is brain in acute stroke treatment. With every 15 minute reduction in door-to-tPA time, it is said to have a 5% reduction in mortality. Best practice indicates that essential diagnostic tests must occur within 45 minutes of patient arrival to the Emergency Department. Design: In 2012, Memorial Medical Center launched a Lean Six Sigma project to improve system performance. Lean Six Sigma DMADV (define, measure, analyze, design, validate) methodology was used to completely redesign the ED stroke diagnostic process. Setting: The setting was at a Midwestern Level 1 Trauma Center approx 70,000 visits each year. Participants/Subjects: The study sample consisted of 142 consecutive patients meeting acute stroke criteria during period April 2012 through June 2013. Methods: There were weekly team reviews of statistical process control charts of system performance that identified gaps between the current and ideal state, which resulted in new standardized sequence for test completion, prioritization, role clarification, and communication enhancement. Results/Outcomes: An improvement to the ED stroke diagnostic process was implemented and was named STROKE *45. This is a new clinical process that reflects Joint Commission accreditation guidelines, industry leading organization best practices, and evidence-based care pathways that dramatically reduce system variability and inefficiency. The STROKE *45 process decreased the average door to diagnostic test completion time by 65% (from 114 minutes down to 40 minutes), resulting reduction in door-to-tPA time by 40% (from 122 minutes to 73 minutes). Implications: Lean Six Sigma is a powerful operations improvement method for today’s healthcare environment, promoting gains in quality, safety, service and cost. This data-based approach aligns with the scientific method but requires strong interdisciplinary team work, real-time monitoring of results, managerial and physician leader engagement and willingness to confront resistances to changing the status quo. STROKE *45 produced outstanding improvements in our primary stroke center that have now been extended to system critical access hospitals with similar results. Overall, the Lean Six Sigma DMADV (define, measure, analyze, design, validate) model fostered dramatic and sustained clinical improvements, yielding a more robust system of care for regional patients presenting with this disabling acute neurological emergency.
Keywords:
Stroke; Time is Brain
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleSTROKE*45en_GB
dc.contributor.authorHudelson, Kadien_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsKadi Hudelson, RN, hudelson.kadi@mhsil.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344143-
dc.description.abstractEvidence-based Practice Abstract Purpose: Stroke is a major cause of disability and death. Therefore, time is brain in acute stroke treatment. With every 15 minute reduction in door-to-tPA time, it is said to have a 5% reduction in mortality. Best practice indicates that essential diagnostic tests must occur within 45 minutes of patient arrival to the Emergency Department. Design: In 2012, Memorial Medical Center launched a Lean Six Sigma project to improve system performance. Lean Six Sigma DMADV (define, measure, analyze, design, validate) methodology was used to completely redesign the ED stroke diagnostic process. Setting: The setting was at a Midwestern Level 1 Trauma Center approx 70,000 visits each year. Participants/Subjects: The study sample consisted of 142 consecutive patients meeting acute stroke criteria during period April 2012 through June 2013. Methods: There were weekly team reviews of statistical process control charts of system performance that identified gaps between the current and ideal state, which resulted in new standardized sequence for test completion, prioritization, role clarification, and communication enhancement. Results/Outcomes: An improvement to the ED stroke diagnostic process was implemented and was named STROKE *45. This is a new clinical process that reflects Joint Commission accreditation guidelines, industry leading organization best practices, and evidence-based care pathways that dramatically reduce system variability and inefficiency. The STROKE *45 process decreased the average door to diagnostic test completion time by 65% (from 114 minutes down to 40 minutes), resulting reduction in door-to-tPA time by 40% (from 122 minutes to 73 minutes). Implications: Lean Six Sigma is a powerful operations improvement method for today’s healthcare environment, promoting gains in quality, safety, service and cost. This data-based approach aligns with the scientific method but requires strong interdisciplinary team work, real-time monitoring of results, managerial and physician leader engagement and willingness to confront resistances to changing the status quo. STROKE *45 produced outstanding improvements in our primary stroke center that have now been extended to system critical access hospitals with similar results. Overall, the Lean Six Sigma DMADV (define, measure, analyze, design, validate) model fostered dramatic and sustained clinical improvements, yielding a more robust system of care for regional patients presenting with this disabling acute neurological emergency.en_GB
dc.subjectStrokeen_GB
dc.subjectTime is Brainen_GB
dc.date.available2015-02-04T11:27:15Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:15Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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