E-Mail Is an Effective Tool for Rapid Feedback in Acute Stroke

Lazy, lazy, lazy. The goal is administration of tPA in the ambulance, in negative time, DTN is way too fucking late. It can be done, just look at these fast diagnosis tools;
But are these other fast stroke diagnosis tools good enough to roll out to the world? Do you even know about them?

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds

 

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds

 

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes

 Maybe these 17 diagnosis possibilities to find out which one is the best? Or maybe the Qualcomm Xprize for the tricorder?

 The lazy quality improvement project here:

E-Mail Is an Effective Tool for Rapid Feedback in Acute Stroke

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Sara K. Rostanski, MD, Joshua I. Stillman, MD, Lauren R. Schaff, MD, ...

First Published January 17, 2017 Research Article

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Abstract

Objective:

To determine whether e-mail is a useful mechanism to provide prompt, case-specific data feedback and improve door-to-needle (DTN) time for acute ischemic stroke treated with intravenous tissue plasminogen activator (IV-tPA) in the emergency department (ED) at a high-volume academic stroke center.

Methods:

We instituted a quality improvement project at Columbia University Medical Center where clinical details are shared via e-mail with the entire treatment team after every case of IV-tPA administration in the ED. Door-to-needle and component times were compared between the prefeedback (January 2013 to March 2015) and postfeedback intervention (April 2015 to June 2016) periods.

Results:

A total of 273 cases were included in this analysis, 102 (37%) in the postintervention period. Median door-to-stroke code activation (2 vs 0 minutes, P < .01), door-to-CT Scan (21 vs 18 minutes, P < .01), and DTN (54 vs 49 minutes, P = .17) times were shorter in the postintervention period, although the latter did not reach statistical significance. The proportion of cases with the fastest DTN (≤45 minutes) was higher in the postintervention period (29.2% vs 42.2%, P = .03).

Conclusion:

E-mail is a simple and effective tool to provide rapid feedback and promote interdisciplinary communication to improve acute stroke care in the ED.