Stroke Stat: Notification System for In-Hospital Acute Strokes (P3.163)

Objective: To: 1) Assess the existing management protocol and determinants of delays in acute inpatient stroke evaluations. 2) Standardize the protocol for inpatient code-stroke. 3) Evaluate the effectiveness of the new inpatient code-stroke protocol, “Stroke Stat.” Background: It is well established that inpatient acute strokes have delays in evaluation and worse outcomes. Our hospital has two separate inpatient campuses making timely evaluation and imaging challenging. Additionally, the complexity of our paging system makes it unclear to other clinicians which neurology resident should be paged for acute inpatient stroke evaluations. Design/Methods: Between 11/2016 and 6/2017, the time, recipient, and contents of pages for all inpatient code-strokes were recorded. In 6/2017, we conducted hospital-wide education programs for clinicians and nursing staff regarding recognition of acute strokes and introduced our new protocol “Stroke Stat.” This is a one-page notification system that simultaneously alerts the stroke fellow, neurology resident, CT technologist, and nurse managers on both campuses. Stroke Stat was implemented on 7/1/2017, and we evaluated the page quality and notification-to-imaging time before and after 7/1/2017. Results: Between 11/2016 and 6/2017, 84 inpatient code-stroke pages were recorded with time of page available in 30/84 cases. The pages were sent to the incorrect recipients in 35/84 cases (43%) and lacked pertinent patient information in 34/37 (92%). Six “Stroke Stat” pages were activated between 7/2017 and 9/2017 and all notified the appropriate team members with adequate information. Notification-to-imaging time decreased from an average of 29.4 minutes (range 4–67) pre “Stroke Stat” to 19.8 minutes (range 5–46) post-intervention (mean difference 9.9 minutes, 95% CI −3 to 22.9, not significant, imprecise, small sample). Data collection and analyses are ongoing. Conclusions: We developed “Stroke Stat” as a potential protocol for timely management of inpatient acute strokes. Updated analyses of effectiveness of “Stroke-Stat” will be presented. Disclosure: Dr. Alderson has nothing to disclose. Dr. Ayub has nothing to disclose. Dr. Ho has nothing to disclose. Dr. Lin has nothing to disclose. Dr. Kumar has nothing to disclose. Dr. Selim has nothing to disclose. Dr. Narayanaswami has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with expert medical reports for Advanced Medical, Serve on Pharmacy and Therapeutics Committee of Blue Cross Blue Shield of MA. Dr. Narayanaswami has received personal compensation in an editorial capacity for Associate Editor, Muscle and Nerve.