During an ischemic stroke, every minute untreated results in the loss of 1.9 million neurons. This makes timely treatment essential, particularly for patients who qualify for Endovascular Stroke Treatment (EST), which aims to restore blood flow to the brain. A team of nurses, physicians, technicians, and other ancillary members worked together on a quality improvement project in the Sacramento Emergency Department (ED) focused on reducing the time between patient arrival and Neurointerventional Radiology (NIR) treatment by redesigning the flow and processes.
As a Comprehensive Stroke Center, the hospital must have efficient processes and systems in place to support the needs of patients seeking advanced neurologic care due to stroke. The project’s goal was to decrease the Door-In-Door-In (DIDI) time, the interval from ED arrival to NIR, to under 65 minutes for at least 35% of qualified patients. Previously, this target was not being met, and barriers to faster treatment were identified.
“One major adjustment we made was keeping patients in the CT suite to assess for large vessel occlusion rather than sending them back to the ED. This simple change allowed staff to remain with the patient, reducing delays and ensuring a seamless transfer to NIR,” shares Christine Swanson, BS, ADN, RN, Staff Nurse II, Emergency Department. “We also implemented direct access to the EST phone line, which significantly improved communication and speeded up report handoffs for faster patient transport. We educated ED staff on the locations of Neuro IR supplies and streamlined workflows for both business and after-hours operations. These changes have made a meaningful impact on efficiency and patient outcomes.” The project has reduced delays and ensured more efficient care, helping to meet the <65-minute DIDI goal and faster EST times.