One-Stop Management to Initiate Thrombolytic Treatment on the Computed Tomography Table: Adoption and Results

Data from clinical practice show that median door-to-needle time (DNT) for intravenous thrombolysis (IVT) remains around 60 minutes. However, many reports documented that hospital logistics could be substantially streamlined and DNT shortened below 30 minutes. Given Czech stroke care reform, many stroke centers have recently been changing their logistical pathways with the aim to initiate IVT quicker than before.3 Several stroke centers introduced one-stop management, which means that all suspected acute ischemic stroke (AIS) patients are admitted directly to the computed tomography (CT) room and IVT is initiated on the CT table. As a consequence, our national data show that some hospitals were able to reach an extremely short DNT, while others were not. The aim of this nationwide study was to understand how logistical pathways are being used, and how they impact quality of patient care as measured by DNT.