SHARED LEADERSHIP Committee introduces changes to improve outcomes for stroke patients WELLSTAR PAULDING MEDICAL CENTER Hospital takes action to reduce the time between a patient’s arrival in the emergency department and administration of a potentially life-saving drug.
One of the stroke treatments in use at Wellstar Paulding Medical Center (WPMC) is timely delivery of the clot-dissolving medication Tenecteplase. In 2022, the Emergency Department found itself above the door-to-needle (D2N) period recommended by the American Heart Association and American Stroke Association (45 minutes for 50% or more of acute stroke patients). The WPMC Acute Stroke Committee jumped into action. The interdisciplinary group is co- led by Alicia Allen, MSN, RN, CEN, director of emergency services, and Cathleen Gibson-Starling, BSN, RN, AMB-BC, emergency services manager. A review of data found that one area of concern was a lack of documentation about reasons for the delays.
Steps toward improvement included mock drills led by stroke program coordinator Teresa Hale, MSN, RN, CEN, to evaluate standard workflow, processes and response times. The committee discussed ways to notify radiology teams to expedite alerts for patients presenting with acute signs and symptoms of stroke. In addition, clinicians were instructed on documentation best practices by committee physician lead Dr. David Schulze. These and other interventions helped achieve the goal of reducing WPMC’s D2N time to under 37 minutes. The achievement has been widely recognized within and beyond Wellstar. n
Mean Tenecteplase Door-to-Needle Time (in minutes)
40% reduction
55 minutes
41 minutes
37 minutes
33 minutes
Q2 2022 (Apr-Jun)
Q3-4 2022 (Jul-Dec)
Q1 2023 (Jan-Mar)
Q2 2023 (Apr-Jun)
Q3 2023 (Jul-Sep)
n Pre-intervention
n Post-intervention
22 | WELLSTAR HEALTH SYSTEM
Made with FlippingBook - Online catalogs