North Fulton Hospital Improves Emergency Care for Stroke Patients

A North Fulton Hospital project that improved stroke care earned the medical facility a patient safety award.

The Partnership for Health and Accountability presented its Quality and Patient Safety Award to the hospital for its project, titled "Time is Brain: Multidisciplinary Approach to the Emergency Care of the Stroke Patient." The project won third place in the Hospitals with 100 to 299 Beds Category.

The goal of North Fulton's project was to improve the efficiency of the hospital's stroke program and treatment of ischemic strokes, which occur as the result of an obstruction in a blood vessel supplying blood to the brain.

According to the American Stroke Association, the only approved treatment for these types of strokes is tissue plasminogen activator (tPA). This treatment dissolves the clot and is given intravenously through the arm. Objectives of the project were to reduce tPA administration time to less than 60 minutes after patient arrival; to increase utilization of tPA; and to require head CT scan results within 45 minutes of patient arrival.

Staff neurologists developed a stroke protocol that required them to be at the patient's bedside within 30 minutes of notification of the patient's arrival. Additionally, the hospital stroke coordinator developed a module for emergency department and critical care nurses that outlined the steps required to mix and administer the tPA.

Whenever emergency medical services staff alerted the hospital of the arrival of a stroke patient, staff members were notified so they could prepare the CT scanner and ensure it would be ready when the patient arrived. Additionally, the emergency department physician requested that the CT results be available within 45 minutes.

Door to tPA time was reduced from 91.3 minutes to 64.4 minutes. Door to CT time was reduced from 48.8 minutes to 41.4 minutes.