Techniques from the auto industry are giving stroke patients at Barnes-Jewish Hospital a chance at better outcomes.
The sooner stroke patients get the clot-busting drug tPA, the better their chance of survival and a fuller recovery. In 2010, the median time for stroke patients to receive tPA was 55 to 60 minutes from arrival in the Barnes-Jewish emergency department—one of the fastest times in the United States.
But the emergency department team wanted to make that even faster.
By applying Lean principles, first developed by Japanese car manufacturers to maximize value to customers and reduce waste, the team worked to revamp the stroke treatment process.
Last year, a team that included clinicians and front-line emergency department personnel met for a three-day, rapid-improvement event (RIE) to map out ways to make the process faster.
Resulting changes included having emergency transport personnel take patients to the CT scanner as soon as they arrived at Barnes-Jewish, and having the treatment team huddle in the CT area to exchange information.
As a result, in the months since the RIE, the Barnes-Jewish emergency department stroke team has sustained a median door-to-needle time of 30 minutes.
The team’s next goal will be to sustain a 30-minute median.
