From Outlook Magazine…
PHYSICIANS TODAY KNOW that time makes all the difference when it comes to stroke.
The brain is unforgiving to lack of oxygen. Without it, 1.9 million brain cells die every minute. But with prompt treatment, significant disability can be minimized. Hence, “time is brain” now is a nationally recognized stroke awareness campaign.
Leading School of Medicine specialists have worked vigilantly to beat the clock. As a result, patients seen at the Washington University and Barnes-Jewish Stroke & Cerebrovascular Center have improved outcomes and are given the best chance for survival and recovery.
The multidisciplinary team provides some of the fastest stroke critical care in the U.S. — assembling in the Emergency Department within minutes and bringing deep resources to the high-stakes task of stroke diagnosis and treatment.
Further, School of Medicine physicians are helping to shape treatment regionally and nationally as they define and propose time-critical standards and continue to pioneer methods of evaluating and managing stroke.
Transforming a complex process
How does a broadscale team — involving emergency medicine physicians, neurologists, neurosurgeons, radiologists, interventional neuroradiologists and dozens of ancillary staff — become that nimble?
In 2010, the median D2N time in the Barnes-Jewish Emergency Department (ED) was 55 to 60 minutes, but the stroke team determined it could do better by applying lean manufacturing principles developed by the Japanese car manufacturer Toyota.
Team members met for two days with lean engineers to examine each of the 50-plus steps leading to tPA administration. Each step — from patient registration and vital signs monitoring to labs and imaging — was evaluated from an efficiency perspective. The objective was to reduce bottlenecks, improve teamwork and communication and ensure that those caring for patients have easy access to supplies and equipment.
“We sought suggestions from everyone involved, from the paramedics who bring in patients, to admitting clerks, radiology technologists, nurses and physicians,” said Jin-Moo Lee, MD, PhD,senior author of the study that was published in Stroke. Lee is a Washington University neurologist at Barnes-Jewish Hospital and director of the Department of Neurology’s cerebrovascular disease section.
The complex treatment process could be streamlined, they decided — even before patients arrive at the hospital.
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