Automating stroke response for efficiency and effectiveness

stroke response time success story

When a patient exhibits symptoms of a potential stroke, time is the most important consideration in the battle between life and death. As they continually strive to deliver the best patient care, healthcare systems work to reduce the time involved in every segment of the process: door to tPA; door to CT; rst neurology exam; and more. The strongest programs are able to meet the criteria to become credentialed as Primary Certi ed Stroke Centers. One such program is Genesys Regional Medical Center in Michigan.

According to Rebecca Banat, RN, Director, Neuroscience, Stroke Center, Neuro Tele-Med & Oncology Services at Genesys Regional Medical Center, “We have been accredited as a certi ed stroke center three times, but we knew we still had opportunities for improvement.” Some of the issues they faced were:

  • A pager system that was unreliable, with delayed delivery of messages
  • Inconsistent messaging content, which led to confusion among responding clinicians
  • A work-around that used overhead paging, disrupting the hospital’s intent to provide a quiet healing environment

The solution

In 2010, Genesys worked with a sister ministry at St. John Providence for support of its neurovascular programs. When it became clear that this was not a good long-term solution, Genesys developed a contractual relationship with eight neurologists who would provide coverage for the stroke program.

With a goal of neurologist response-to-page in 15 minutes or less, Genesys leadership knew they needed a better system. The neurologists couldn’t be held accountable for responding when the systems contacting them were inconsistent and unreliable. And Genesys needed an escalation process if the physicians didn’t respond. With implementation of PerfectServe, Genesys believes it has found the solution.

“We are still early in the process, having just gone live on May 5,” said Banat. “But we have high stroke volumes — as many as 50-60 patients per month — so we were able to see most of the issues and tweak the system early in the change process. We’re on the right path.”

Results

Results are admittedly anecdotal to date, but according to Banat, Genesys is already seeing positive change:

  • There had been as many as 30-50 people on the stroke team at any given time. With individual paging, the last people on the list could have pages delayed by as much as 20-30 minutes.
  • In the past, emergency physicians didn’t call the neurologists until after they had assessed the patient, a potential delay of 45 minutes or more. Now, EMS and emergency physicians contact the neurologists immediately through PerfectServe and quickly involve them in the process. Emergency department physicians and neurologists are becoming more collaborative and effective as a result.
  • Neurologists are responding in a matter of a few minutes or less. And if they don’t respond, the escalation process alerts the Medical Director, who becomes involved and keeps the communication moving.
  • EMS has adopted new processes to call ahead and relay information, including expected time of arrival, glucose count and other symptoms, before transport to the emergency department, so the hospital team is prepared. And EMS now transports directly to Radiology for CT scans, further reducing treatment time.
  • Ancillary department turnaround times appear to have decreased. And the frontline staff are no longer worried about delays or inconsistent information.
  • The Medical Director has a better understanding of the intricacies of the process and is able to identify trends and issues in the program for intervention and improvement.
  • Call schedules are automated in the system so they can be easily changed. Previously, call schedules were handwritten and nurses and office staff had to contact many physicians to make changes.

Going forward

Genesys is early in its implementation of PerfectServe, but Banat views the program as a pilot. “In talking to peers in other services, like trauma, they can’t wait to get the system implemented,” noted Banat. “They have to deal with manual records and weekly reports. PerfectServe gives us automated, real-time information.”

New processes can sometimes create resistance to change. But Banat says the “results, and the realization that this system makes their clinical practice easier, more consistent and reliable, and most importantly improves patient care, have created tremendous support for PerfectServe.”

As the process is fully implemented, Genesys has set aggressive goals. While the Joint Commission’s requirement is “door-to-drip” (arrival to tPA infusion) in 60 minutes, 50 percent of the time, Genesys is aiming for 45 minutes, 100 percent of the time.

About Genesys Health System

Genesys Health System is a member of Ascension Health, the largest not-for-profit health system in the United States.

Genesys Health System is a group of affiliated medical campuses, outpatient centers, primary care locations and ancillary healthcare organizations with a mission and history of improving the community’s health for more than 90 years. As the leading healthcare provider in mid-Michigan, Genesys is anchored by a 21st-century inpatient facility — Genesys Regional Medical Center at Health Park — one of the first medical centers of its kind built both clinically and architecturally around a patient-focused care philosophy. Genesys Regional Medical Center is a 400-bed center that includes a level II verified emergency trauma center with a cardiac rapid diagnostic center, the Genesys Heart Institute, the Genesys Family Birthing Center and expanded clinical expertise in neurosciences, orthopedics, geriatric services, oncology and minimally invasive surgical procedures in almost every specialty area.

About PerfectServe

PerfectServe provides healthcare’s only comprehensive and secure communication and collaboration platform. The company’s flagship solution, PerfectServe, unites physicians, nurses and other care team members across the continuum and facilitates timely interaction among them.

PerfectServe automatically identifies and provides immediate access to the right care team member, enabling effective population health management through communication-driven workflows. More than 100,000 clinicians in organizations such as Advocate Healthcare, Ascension Health, Covenant Medical Group, Hoag, MemorialCare Health System, Orlando Health, St. Joseph Health and WellStar Health System rely on PerfectServe to help them speed time to treatment, promote physician alignment, enhance the consult process, increase transition efficiency, provide nurses more time for direct patient care and reduce HIPAA compliance risk. Headquartered in Knoxville, Tennessee, PerfectServe has been serving the needs of forward-looking healthcare provider organizations since 2000.

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