An Acute Stroke Evaluation App A Practice Improvement Project

Well shit, something minimally effective. Now if we could just get our stroke medical teams to solve all the f*cking problems in stroke and create stroke rehabilitation protocols then maybe they might be worth paying. This would means thousands of hospitals trying to come up with something effective and useful as compared to having a great stroke association solve this for everyone worldwide. But we don't have anything close to a great stroke association.  You'll have to deal with your post-stroke disabilities  for the next 50 years because nothing useful will come before that under the current leadership.
http://nho.sagepub.com/content/5/2/63?etoc

1. Mark N. Rubin, MD1
2. Jennifer E. Fugate, DO2
3. Kevin M. Barrett, MD, MSc3
4. Alejandro A. Rabinstein, MD2
5. Kelly D. Flemming, MD2⇑

1. ¹Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA
2. ²Department of Neurology, Mayo Clinic, Rochester, MN, USA
3. ³Department of Neurology, Mayo Clinic, Jacksonville, FL, USA

1. Kelly D. Flemming, Department of Neurology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA. Email: flemming.kelly@mayo.edu

Abstract

A point-of-care workflow checklist in the form of an iOS (iPhone Operating System) app for use by stroke providers was introduced with the objective of standardizing acute stroke evaluation and documentation at 2 affiliated academic medical centers. Providers used the app in unselected, consecutive patients undergoing acute stroke evaluation in an emergency department or hospital setting between August 2012 and January 2013 and August 2013 and February 2014. Satisfaction surveys were prospectively collected pre- and postintervention from residents, staff neurologists, and clinical data specialists. Residents (20 preintervention and 16 postintervention), staff neurologists (6 pre and 5 post), and clinical data specialists (4 pre and 4 post) participated in this study. All 16 (100%) residents had increased satisfaction with their ability to perform an acute stroke evaluation postintervention but only 9 (56%) of 16 felt the app was more help than hindrance. Historical controls aligned with preintervention results. Staff neurologists conveyed increased satisfaction with resident presentations and decision making when compared to preintervention surveys. Stroke clinical data specialists estimated a 50% decrease in data abstraction when the app data were used in the clinical note. Concomitant effect on door-to-needle (DTN) time at 1 site, although not a primary study measure, was also evaluated. At that 1 center, the mean DTN time decreased by 16 minutes when compared to the corresponding months from the year prior. The point-of-care acute stroke workflow checklist app may assist trainees in presenting findings in a standardized manner and reduce data abstraction time. The app may help reduce DTN time, but this requires further study.