A computerized in-hospital alert system for thrombolysis in acute stroke

Jihoe Heo, Young Dae Kim, Hyo Suk Nam, Keun Sik Hong, Seong Hwan Ahn, Hyun Ji Cho, Hye Yeon Choi, Sang Won Han, Myoung Jin Cha, Ji Man Hong, Gyeong Moon Kim, Gyu Sik Kim, Hye Jin Kim, Seo Hyun Kim, Yong Jae Kim, Sun Uck Kwon, Byung Chul Lee, Jun Hong Lee, Kwang Ho Lee, Mi Sun Oh

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background and Purpose-: An effective stroke code system that can expedite rapid thrombolytic treatment requires effective notification/communication and an organized team approach. We developed a stroke code program based on the computerized physician order entry (CPOE) system and investigated whether implementation of this CPOE-based program is useful for reducing the time from arrival at emergency departments (ED) to evaluation steps and the initiation of thrombolytic treatment in various hospital settings. Methods-: The CPOE-based program was implemented by 10 hospitals. Time intervals from arrival at the ED to blood tests, computed tomography scanning, and thrombolytic treatment during the 1-year period before and the 1-year period after the program implementation were compared. Results-: Time intervals from ED arrival to evaluation steps were significantly reduced after implementation of the CPOE-based program. Times from ED arrival to CT scan, complete blood counts, and prothrombin time testing were reduced by 7.7 minutes, 5.6 minutes, and 26.8 minutes, respectively (P<0.001). The time from ED arrival to intravenous thrombolysis was reduced from 71.7±33.6 minutes to 56.6±26.9 minutes (P<0.001). The number of patients who were treated with thrombolysis increased from 3.4% (199/5798 patients) before the CPOE-based program to 5.8% (312/5405 patients) afterward (P<0.001). The CPOE implementation also improved the inverse relationship between onset-to-door time and door-to-needle time. Conclusions-: The CPOE-based stroke code could be successfully implemented to reduce in-hospital time delay in thrombolytic therapy in various hospital settings. CPOE may be used as an efficient tool to facilitate in-hospital notification/communication and an organized team approach.

Original languageEnglish
Pages (from-to)1978-1983
Number of pages6
JournalStroke
Volume41
Issue number9
DOIs
Publication statusPublished - 2010 Sep 1

Fingerprint

Medical Order Entry Systems
Stroke
Hospital Emergency Service
Communication
Blood Cell Count
Prothrombin Time
Thrombolytic Therapy
Hematologic Tests
Needles
Therapeutics
Tomography

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Heo, J., Kim, Y. D., Nam, H. S., Hong, K. S., Ahn, S. H., Cho, H. J., ... Oh, M. S. (2010). A computerized in-hospital alert system for thrombolysis in acute stroke. Stroke, 41(9), 1978-1983. https://doi.org/10.1161/STROKEAHA.110.583591
Heo, Jihoe ; Kim, Young Dae ; Nam, Hyo Suk ; Hong, Keun Sik ; Ahn, Seong Hwan ; Cho, Hyun Ji ; Choi, Hye Yeon ; Han, Sang Won ; Cha, Myoung Jin ; Hong, Ji Man ; Kim, Gyeong Moon ; Kim, Gyu Sik ; Kim, Hye Jin ; Kim, Seo Hyun ; Kim, Yong Jae ; Kwon, Sun Uck ; Lee, Byung Chul ; Lee, Jun Hong ; Lee, Kwang Ho ; Oh, Mi Sun. / A computerized in-hospital alert system for thrombolysis in acute stroke. In: Stroke. 2010 ; Vol. 41, No. 9. pp. 1978-1983.
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abstract = "Background and Purpose-: An effective stroke code system that can expedite rapid thrombolytic treatment requires effective notification/communication and an organized team approach. We developed a stroke code program based on the computerized physician order entry (CPOE) system and investigated whether implementation of this CPOE-based program is useful for reducing the time from arrival at emergency departments (ED) to evaluation steps and the initiation of thrombolytic treatment in various hospital settings. Methods-: The CPOE-based program was implemented by 10 hospitals. Time intervals from arrival at the ED to blood tests, computed tomography scanning, and thrombolytic treatment during the 1-year period before and the 1-year period after the program implementation were compared. Results-: Time intervals from ED arrival to evaluation steps were significantly reduced after implementation of the CPOE-based program. Times from ED arrival to CT scan, complete blood counts, and prothrombin time testing were reduced by 7.7 minutes, 5.6 minutes, and 26.8 minutes, respectively (P<0.001). The time from ED arrival to intravenous thrombolysis was reduced from 71.7±33.6 minutes to 56.6±26.9 minutes (P<0.001). The number of patients who were treated with thrombolysis increased from 3.4{\%} (199/5798 patients) before the CPOE-based program to 5.8{\%} (312/5405 patients) afterward (P<0.001). The CPOE implementation also improved the inverse relationship between onset-to-door time and door-to-needle time. Conclusions-: The CPOE-based stroke code could be successfully implemented to reduce in-hospital time delay in thrombolytic therapy in various hospital settings. CPOE may be used as an efficient tool to facilitate in-hospital notification/communication and an organized team approach.",
author = "Jihoe Heo and Kim, {Young Dae} and Nam, {Hyo Suk} and Hong, {Keun Sik} and Ahn, {Seong Hwan} and Cho, {Hyun Ji} and Choi, {Hye Yeon} and Han, {Sang Won} and Cha, {Myoung Jin} and Hong, {Ji Man} and Kim, {Gyeong Moon} and Kim, {Gyu Sik} and Kim, {Hye Jin} and Kim, {Seo Hyun} and Kim, {Yong Jae} and Kwon, {Sun Uck} and Lee, {Byung Chul} and Lee, {Jun Hong} and Lee, {Kwang Ho} and Oh, {Mi Sun}",
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Heo, J, Kim, YD, Nam, HS, Hong, KS, Ahn, SH, Cho, HJ, Choi, HY, Han, SW, Cha, MJ, Hong, JM, Kim, GM, Kim, GS, Kim, HJ, Kim, SH, Kim, YJ, Kwon, SU, Lee, BC, Lee, JH, Lee, KH & Oh, MS 2010, 'A computerized in-hospital alert system for thrombolysis in acute stroke', Stroke, vol. 41, no. 9, pp. 1978-1983. https://doi.org/10.1161/STROKEAHA.110.583591

A computerized in-hospital alert system for thrombolysis in acute stroke. / Heo, Jihoe; Kim, Young Dae; Nam, Hyo Suk; Hong, Keun Sik; Ahn, Seong Hwan; Cho, Hyun Ji; Choi, Hye Yeon; Han, Sang Won; Cha, Myoung Jin; Hong, Ji Man; Kim, Gyeong Moon; Kim, Gyu Sik; Kim, Hye Jin; Kim, Seo Hyun; Kim, Yong Jae; Kwon, Sun Uck; Lee, Byung Chul; Lee, Jun Hong; Lee, Kwang Ho; Oh, Mi Sun.

In: Stroke, Vol. 41, No. 9, 01.09.2010, p. 1978-1983.

Research output: Contribution to journalArticle

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AU - Heo, Jihoe

AU - Kim, Young Dae

AU - Nam, Hyo Suk

AU - Hong, Keun Sik

AU - Ahn, Seong Hwan

AU - Cho, Hyun Ji

AU - Choi, Hye Yeon

AU - Han, Sang Won

AU - Cha, Myoung Jin

AU - Hong, Ji Man

AU - Kim, Gyeong Moon

AU - Kim, Gyu Sik

AU - Kim, Hye Jin

AU - Kim, Seo Hyun

AU - Kim, Yong Jae

AU - Kwon, Sun Uck

AU - Lee, Byung Chul

AU - Lee, Jun Hong

AU - Lee, Kwang Ho

AU - Oh, Mi Sun

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N2 - Background and Purpose-: An effective stroke code system that can expedite rapid thrombolytic treatment requires effective notification/communication and an organized team approach. We developed a stroke code program based on the computerized physician order entry (CPOE) system and investigated whether implementation of this CPOE-based program is useful for reducing the time from arrival at emergency departments (ED) to evaluation steps and the initiation of thrombolytic treatment in various hospital settings. Methods-: The CPOE-based program was implemented by 10 hospitals. Time intervals from arrival at the ED to blood tests, computed tomography scanning, and thrombolytic treatment during the 1-year period before and the 1-year period after the program implementation were compared. Results-: Time intervals from ED arrival to evaluation steps were significantly reduced after implementation of the CPOE-based program. Times from ED arrival to CT scan, complete blood counts, and prothrombin time testing were reduced by 7.7 minutes, 5.6 minutes, and 26.8 minutes, respectively (P<0.001). The time from ED arrival to intravenous thrombolysis was reduced from 71.7±33.6 minutes to 56.6±26.9 minutes (P<0.001). The number of patients who were treated with thrombolysis increased from 3.4% (199/5798 patients) before the CPOE-based program to 5.8% (312/5405 patients) afterward (P<0.001). The CPOE implementation also improved the inverse relationship between onset-to-door time and door-to-needle time. Conclusions-: The CPOE-based stroke code could be successfully implemented to reduce in-hospital time delay in thrombolytic therapy in various hospital settings. CPOE may be used as an efficient tool to facilitate in-hospital notification/communication and an organized team approach.

AB - Background and Purpose-: An effective stroke code system that can expedite rapid thrombolytic treatment requires effective notification/communication and an organized team approach. We developed a stroke code program based on the computerized physician order entry (CPOE) system and investigated whether implementation of this CPOE-based program is useful for reducing the time from arrival at emergency departments (ED) to evaluation steps and the initiation of thrombolytic treatment in various hospital settings. Methods-: The CPOE-based program was implemented by 10 hospitals. Time intervals from arrival at the ED to blood tests, computed tomography scanning, and thrombolytic treatment during the 1-year period before and the 1-year period after the program implementation were compared. Results-: Time intervals from ED arrival to evaluation steps were significantly reduced after implementation of the CPOE-based program. Times from ED arrival to CT scan, complete blood counts, and prothrombin time testing were reduced by 7.7 minutes, 5.6 minutes, and 26.8 minutes, respectively (P<0.001). The time from ED arrival to intravenous thrombolysis was reduced from 71.7±33.6 minutes to 56.6±26.9 minutes (P<0.001). The number of patients who were treated with thrombolysis increased from 3.4% (199/5798 patients) before the CPOE-based program to 5.8% (312/5405 patients) afterward (P<0.001). The CPOE implementation also improved the inverse relationship between onset-to-door time and door-to-needle time. Conclusions-: The CPOE-based stroke code could be successfully implemented to reduce in-hospital time delay in thrombolytic therapy in various hospital settings. CPOE may be used as an efficient tool to facilitate in-hospital notification/communication and an organized team approach.

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