Effective stroke treatments exist, but timely access to these treatments is not always available to rural and community hospitals and the patients they serve. These hospitals face challenges with availability of onsite specialty providers, obtaining capital to purchase costly interventional equipment and arranging for timely transfer of patients to tertiary care facilities. In 2019, Geneva General Hospital (a member of Finger Lakes Health) began implementing process changes to improve stroke care at its rural hospital.
In collaboration with regional emergency medical services providers and their tertiary referral center, GGH overcame several challenges affecting the care of stroke patients. With support of the radiology team, staff operationalized changes in physician notification of stroke-like symptoms and rapid redeployment of intradepartmental resources. Using a Plan-Do-Study-Act approach, they isolated steps in the triage, diagnostics, clinical care, treatment and disposition of stroke patients to effectuate improvement.
Treatment response times for stroke care were reduced by 61%. Additionally, there was a dramatic decrease in door-to-needle time, down nearly 30 minutes from patient arrival to Alteplase given. GGH also saw a 250% increase in the number of times Alteplase was given between 2019 and 2020.
For more information, contact Kathleen Reilly, director, quality and performance improvement, at kathleen.reilly@flhealth.org or 315.787.4176.