Study: Lean Approach Speeds Treatment for Stroke Patients

A Lean manufacturing approach to stroke care can speed the time from patients' arrival to their treatment, according to an American Heart Association news release.

Researchers of a study published in Stroke evaluated stroke care for more than 200 patients over three years at Barnes-Jewish Hospital in St. Louis. Researchers measured the average time between patients' arrival and their treatment with the clot-busting agent tissue plasminogen activator; a shorter time increases the likelihood of reducing brain injury after stroke.

The hospital's stroke team used Lean techniques to identify inefficient processes that lengthen patients' time to treatment. The team eliminated non-value-added steps and designed protocols that streamlined stroke care. The new process included the following changes:

•    Emergency medical services routed patients directly to the CT scanner for immediate brain imaging.
•    More team members came onboard, each with fewer tasks to complete.
•    Clinicians performed bedside tests, providing laboratory results within minutes.

As a result of these process changes, the time from arrival to treatment decreased 21 minutes. The overall treatment time decreased from 60 minutes to 39 minutes. In addition, 78 percent of stroke patients received tPA within one hour of arrival, exceeding the national average of roughly 30 percent of patients (as documented in the Get with the Guidelines national database), according to the release.

While the time to treatment improved, the new protocol did not alter patient safety or clinical outcomes, according to the release.

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