Research shows that following the guidelines set by the American Heart Association (AHA) and American Stroke Association (ASA) can significantly reduce hospitals’ response times for stroke treatment, even for medical teams that come together quickly and temporarily.
A study conducted by West Virginia University highlights the effectiveness of AHA and ASA guidelines in speeding up hospitals’ response times for stroke treatment, even for “ad hoc” medical teams that assemble rapidly.
When a stroke patient arrives at the emergency room, specialists from various hospital departments work together urgently to provide treatment. These departments include emergency medical services (EMS), neurologists, pharmacists, physicians, nurses, radiologists, and technicians. The AHA and ASA guidelines set specific time limits for different stages of stroke treatment, from the onset of an ischemic stroke (a blockage in blood flow to the brain) to hospital arrival and treatment administration.
A study published in the Journal of Operations Management by Bernardo Quiroga, an associate professor at WVU John Chambers College of Business and Economics, examined data from over 8,000 stroke patients treated in a large hospital between 2009 and 2017. The study aimed to determine if the communication of best practices outlined by AHA and ASA helps temporary medical teams who may lack prior collaboration experience.
According to Quiroga, time is crucial for stroke patients as delayed treatment can have severe consequences. Rapid coordination among medical professionals is essential to restore blood flow to the brain and mitigate damage. The faster treatment is administered, the better the outcomes, with a clot-dissolving medication called Tissue Plasminogen Activator (TPA) being most effective within the first hours of symptom onset.
In 2010, AHA and ASA introduced Target: Stroke to standardize stroke care best practices and improve treatment processes. Participating hospitals saw a significant reduction in treatment times, from 79 minutes in 2009 to 51 minutes in 2017. The study aimed to determine if this improvement was due to adherence to best practices or increased experience from handling more stroke cases.
The research found that learning through repetition and implementing best practices both contributed to reducing treatment times. Repetitive exposure to stroke cases led to faster responses, while protocols like the Helsinki Model and Rapid Administration of TPA further decreased treatment times beyond experiential learning.
It was highlighted that the presence of a stroke advisory committee played a crucial role in setting targets, evaluating team performances, and providing feedback for sustained adherence to best practices. The challenges in maintaining best practices on temporary medical teams were acknowledged, especially when coordination with external entities like EMS providers is required.
The study concluded that despite the difficulties faced by ad hoc teams in information sharing and learning, the implementation of best practices can lead to sustained improvements in stroke treatment efficiency. Even though individual team members may change, a commitment to learning and following guidelines ensures consistent quality of care for stroke patients.
