A competitive clinical environment improves procedural times in endovascular stroke treatment.
balloon
blood flow
embolic
stroke
thrombectomy
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
28
01
2019
revised:
26
02
2019
accepted:
08
03
2019
pubmed:
16
5
2019
medline:
31
10
2019
entrez:
16
5
2019
Statut:
ppublish
Résumé
Despite numerous optimization attempts, time delays are still a relevant problem in endovascular stroke treatment. We hypothesized that public display of the fastest procedural times in our institution would raise awareness, which would result in improved procedural times. We established a competition, which lasted 6 months, in which the fastest neurovascular team in terms of procedural times (image to reperfusion) was displayed on a public board in our institution and rewarded with public praise. During this time no other relevant procedural or infrastructural means for improvement of procedural times were introduced in our institution. We prospectively evaluated procedural times in 496 patients who received endovascular stroke treatment 9 months before the competition, during the competition, and during the four 6-month time periods for 2 years after the competition. Median image-to-reperfusion times improved significantly from 98 min before the competition to 85 min during the competition (p=0.005) and remained stable with a median of 81 min 2 years after the competition (p=0.837). We were able to improve our procedural times significantly with a simple and cost-efficient competition. This effect was sustained 2 years after the competition was completed, implying that the improvement in procedural times was probably due to raised awareness.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Despite numerous optimization attempts, time delays are still a relevant problem in endovascular stroke treatment. We hypothesized that public display of the fastest procedural times in our institution would raise awareness, which would result in improved procedural times.
METHODS
METHODS
We established a competition, which lasted 6 months, in which the fastest neurovascular team in terms of procedural times (image to reperfusion) was displayed on a public board in our institution and rewarded with public praise. During this time no other relevant procedural or infrastructural means for improvement of procedural times were introduced in our institution. We prospectively evaluated procedural times in 496 patients who received endovascular stroke treatment 9 months before the competition, during the competition, and during the four 6-month time periods for 2 years after the competition.
RESULTS
RESULTS
Median image-to-reperfusion times improved significantly from 98 min before the competition to 85 min during the competition (p=0.005) and remained stable with a median of 81 min 2 years after the competition (p=0.837).
CONCLUSION
CONCLUSIONS
We were able to improve our procedural times significantly with a simple and cost-efficient competition. This effect was sustained 2 years after the competition was completed, implying that the improvement in procedural times was probably due to raised awareness.
Identifiants
pubmed: 31088943
pii: neurintsurg-2019-014768
doi: 10.1136/neurintsurg-2019-014768
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
781-784Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: MW: Consultancy: Stryker. Payment for lectures: Bracco, Medtronic, Siemens, Stryker. Payment for development of educational presentations: Bracco, Codman, Medtronic, Phenox, Siemens.