By: Daniel J. DiLorenzo, MD, PhD, MBA; Danilo Marques Nogueira, MD; Kiffon M. Keigher, ACNP; Demetrius K. Lopes, MD
Newswise — The most important factor in survival and preservation of neurological function in patients with stroke is time for therapy. As with heart attacks, the faster a patient is diagnosed, the sooner the patent receives therapy, the better the outcome. This is not surprising since neurons survive only minutes after their oxygen supply is cut off. In the brain, sometimes adjacent blood vessels can supply some of the much needed blood supply and oxygen, thereby slowing the process and buying some time for a portion of the injured neurons. For this reason, many centers and physicians, including neurosurgeons, neurologists, neuroradiologists and neurointerventionalists have been collaborating to develop and implement more efficient systems to reduce the delay from stroke onset to therapy.
Concerted efforts at our institution and among many across the country have been focusing on improving response times with the objective to improve outcomes. Improvements in response times may be realized by innovations in each of several areas, including: technique, process, technology and communication. In this pilot study, we describe a new technology that helps to streamline the process and substantially improve communication among all members of our interdisciplinary team and that of other collaborating institutions, including referring hospitals and emergency transportation services, such as ambulances and helicopters.
We have pilot tested and describe a new process and technology that enhances communication and offers the potential to improve the performance our stroke team. The “Join App” is a mobile application and is one of several components developed and implemented in a multi-institutional effort to facilitate seamless communication between stroke physicians and other healthcare professionals.
A mobile tracking device is brought with the patient into the ambulance or helicopter and enables tracking of the patient’s location during transportation from the initial (referring) facility to the final (treating) facility. Each team member receives a graphical image showing a map of the region and an icon showing the position of the patient on the map. This allows for rapid assessment and updating of the estimated time of arrival (ETA) of the patient at the treating facility.
Our streamlined process, specially trained team, this mobile application and the complementary infrastructure have enabled our interdisciplinary stroke team to improve performance and reduce door-to-reperfusion times. We are currently studying the impact of these processes on our outcomes, and these are the foci of manuscripts submitted for review and others in preparation.
We believe that this approach to stroke treatment which integrated appropriate infrastructure with real-time mobile communication can streamline the workflow and decrease door-to-reperfusion times and as well as provide improvements in patient outcome. Further studies are warranted and are under way.
Neurosurgery Awareness Month: Observed each August, Neurosurgery Awareness Month brings focus to a variety of neurosurgical conditions and treatments, as well as on neurosurgeons themselves. Additional materials may be found on the AANS.org website, http://www.aans.org/Patient%20Information/Neurosurgery%20Outreach%20Month.aspx.
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