Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients

Joonsang Yoo, Dongbeom Song, Jang Hyun Baek, Kijeong Lee, Yohan Jung, Han Jin Cho, Jae Hoon Yang, Hyun Ji Cho, Hye Yeon Choi, Young Dae Kim, Hyo Suk Nam, Ji Hoe Heo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Stroke may occur during hospital admission (in-hospital stroke). Although patients with in-hospital stroke are potentially good candidates for reperfusion therapy, they often do not receive treatment as rapidly as expected. Aims: We investigated the effect of a code stroke program for in-hospital stroke, which included the use of computerized physician order entry, specific evaluation and treatment protocols for in-hospital stroke patients, and regular education of medical staffs. Methods: We implemented the program in the cardiology and cardiovascular surgery departments/wards (target-ward group) in November 2008. We compared time intervals from symptom onset to evaluation and reperfusion treatment before and after program implementation between the target-ward and other departments/wards (other-ward group). Results: Among 70 consecutive in-hospital stroke patients who received reperfusion therapy between July 2002 and February 2015, 28 and 42 were treated before and after program implementation, respectively. After program implementation, time intervals from symptom onset to neurology notification (50 min vs. 28 min; P = 0.033), symptom onset to brain imaging (91 min vs. 41 min; P < 0.001), and symptom recognition to notification (22 min vs. 9 min; P = 0.011) were reduced in the target-ward group. Finally, times from symptom onset to intravenous tissue plasminogen activator administration and to arterial puncture were reduced by 55 min (120 min vs. 65 min; P < 0.001) and 130 min (295 min vs. 165 min; P < 0.001), respectively. However, time reductions in the other-ward group were not significant. Conclusions: The comprehensive program for in-hospital stroke that included the use of computerized physician order entry was effective in reducing time intervals to evaluation and reperfusion therapy.

Original languageEnglish
Pages (from-to)656-662
Number of pages7
JournalInternational Journal of Stroke
Volume11
Issue number6
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

Reperfusion
Stroke
Medical Order Entry Systems
Therapeutics
Medical Staff
Tissue Plasminogen Activator
Patient Education
Neurology
Clinical Protocols
Cardiology
Punctures
Neuroimaging

All Science Journal Classification (ASJC) codes

  • Neurology

Cite this

Yoo, Joonsang ; Song, Dongbeom ; Baek, Jang Hyun ; Lee, Kijeong ; Jung, Yohan ; Cho, Han Jin ; Yang, Jae Hoon ; Cho, Hyun Ji ; Choi, Hye Yeon ; Kim, Young Dae ; Nam, Hyo Suk ; Heo, Ji Hoe. / Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients. In: International Journal of Stroke. 2016 ; Vol. 11, No. 6. pp. 656-662.
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title = "Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients",
abstract = "Background: Stroke may occur during hospital admission (in-hospital stroke). Although patients with in-hospital stroke are potentially good candidates for reperfusion therapy, they often do not receive treatment as rapidly as expected. Aims: We investigated the effect of a code stroke program for in-hospital stroke, which included the use of computerized physician order entry, specific evaluation and treatment protocols for in-hospital stroke patients, and regular education of medical staffs. Methods: We implemented the program in the cardiology and cardiovascular surgery departments/wards (target-ward group) in November 2008. We compared time intervals from symptom onset to evaluation and reperfusion treatment before and after program implementation between the target-ward and other departments/wards (other-ward group). Results: Among 70 consecutive in-hospital stroke patients who received reperfusion therapy between July 2002 and February 2015, 28 and 42 were treated before and after program implementation, respectively. After program implementation, time intervals from symptom onset to neurology notification (50 min vs. 28 min; P = 0.033), symptom onset to brain imaging (91 min vs. 41 min; P < 0.001), and symptom recognition to notification (22 min vs. 9 min; P = 0.011) were reduced in the target-ward group. Finally, times from symptom onset to intravenous tissue plasminogen activator administration and to arterial puncture were reduced by 55 min (120 min vs. 65 min; P < 0.001) and 130 min (295 min vs. 165 min; P < 0.001), respectively. However, time reductions in the other-ward group were not significant. Conclusions: The comprehensive program for in-hospital stroke that included the use of computerized physician order entry was effective in reducing time intervals to evaluation and reperfusion therapy.",
author = "Joonsang Yoo and Dongbeom Song and Baek, {Jang Hyun} and Kijeong Lee and Yohan Jung and Cho, {Han Jin} and Yang, {Jae Hoon} and Cho, {Hyun Ji} and Choi, {Hye Yeon} and Kim, {Young Dae} and Nam, {Hyo Suk} and Heo, {Ji Hoe}",
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Yoo, J, Song, D, Baek, JH, Lee, K, Jung, Y, Cho, HJ, Yang, JH, Cho, HJ, Choi, HY, Kim, YD, Nam, HS & Heo, JH 2016, 'Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients', International Journal of Stroke, vol. 11, no. 6, pp. 656-662. https://doi.org/10.1177/1747493016641724

Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients. / Yoo, Joonsang; Song, Dongbeom; Baek, Jang Hyun; Lee, Kijeong; Jung, Yohan; Cho, Han Jin; Yang, Jae Hoon; Cho, Hyun Ji; Choi, Hye Yeon; Kim, Young Dae; Nam, Hyo Suk; Heo, Ji Hoe.

In: International Journal of Stroke, Vol. 11, No. 6, 01.08.2016, p. 656-662.

Research output: Contribution to journalArticle

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T1 - Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients

AU - Yoo, Joonsang

AU - Song, Dongbeom

AU - Baek, Jang Hyun

AU - Lee, Kijeong

AU - Jung, Yohan

AU - Cho, Han Jin

AU - Yang, Jae Hoon

AU - Cho, Hyun Ji

AU - Choi, Hye Yeon

AU - Kim, Young Dae

AU - Nam, Hyo Suk

AU - Heo, Ji Hoe

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background: Stroke may occur during hospital admission (in-hospital stroke). Although patients with in-hospital stroke are potentially good candidates for reperfusion therapy, they often do not receive treatment as rapidly as expected. Aims: We investigated the effect of a code stroke program for in-hospital stroke, which included the use of computerized physician order entry, specific evaluation and treatment protocols for in-hospital stroke patients, and regular education of medical staffs. Methods: We implemented the program in the cardiology and cardiovascular surgery departments/wards (target-ward group) in November 2008. We compared time intervals from symptom onset to evaluation and reperfusion treatment before and after program implementation between the target-ward and other departments/wards (other-ward group). Results: Among 70 consecutive in-hospital stroke patients who received reperfusion therapy between July 2002 and February 2015, 28 and 42 were treated before and after program implementation, respectively. After program implementation, time intervals from symptom onset to neurology notification (50 min vs. 28 min; P = 0.033), symptom onset to brain imaging (91 min vs. 41 min; P < 0.001), and symptom recognition to notification (22 min vs. 9 min; P = 0.011) were reduced in the target-ward group. Finally, times from symptom onset to intravenous tissue plasminogen activator administration and to arterial puncture were reduced by 55 min (120 min vs. 65 min; P < 0.001) and 130 min (295 min vs. 165 min; P < 0.001), respectively. However, time reductions in the other-ward group were not significant. Conclusions: The comprehensive program for in-hospital stroke that included the use of computerized physician order entry was effective in reducing time intervals to evaluation and reperfusion therapy.

AB - Background: Stroke may occur during hospital admission (in-hospital stroke). Although patients with in-hospital stroke are potentially good candidates for reperfusion therapy, they often do not receive treatment as rapidly as expected. Aims: We investigated the effect of a code stroke program for in-hospital stroke, which included the use of computerized physician order entry, specific evaluation and treatment protocols for in-hospital stroke patients, and regular education of medical staffs. Methods: We implemented the program in the cardiology and cardiovascular surgery departments/wards (target-ward group) in November 2008. We compared time intervals from symptom onset to evaluation and reperfusion treatment before and after program implementation between the target-ward and other departments/wards (other-ward group). Results: Among 70 consecutive in-hospital stroke patients who received reperfusion therapy between July 2002 and February 2015, 28 and 42 were treated before and after program implementation, respectively. After program implementation, time intervals from symptom onset to neurology notification (50 min vs. 28 min; P = 0.033), symptom onset to brain imaging (91 min vs. 41 min; P < 0.001), and symptom recognition to notification (22 min vs. 9 min; P = 0.011) were reduced in the target-ward group. Finally, times from symptom onset to intravenous tissue plasminogen activator administration and to arterial puncture were reduced by 55 min (120 min vs. 65 min; P < 0.001) and 130 min (295 min vs. 165 min; P < 0.001), respectively. However, time reductions in the other-ward group were not significant. Conclusions: The comprehensive program for in-hospital stroke that included the use of computerized physician order entry was effective in reducing time intervals to evaluation and reperfusion therapy.

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