Viz.ai Implementation of Stroke Augmented Intelligence and Communications Platform to Improve Indicators and Outcomes for a Comprehensive Stroke Center and Network

被引:10
作者
Figurelle, M. E. [1 ]
Meyer, D. M. [1 ]
Perrinez, E. S. [1 ]
Paulson, D. [1 ]
Pannell, J. S. [1 ]
Santiago-Dieppa, D. R. [1 ]
Khalessi, A. A. [1 ]
Bolar, D. S. [1 ]
Bykowski, J. [1 ]
Meyer, B. C. [1 ,2 ]
机构
[1] Univ Calif San Diego, San Diego, CA USA
[2] UC San Diego Hlth, Dept Neurosci, 3rd Med Off North,Suite 3,200 West Arbor Dr, San Diego, CA 92103 USA
关键词
ACUTE ISCHEMIC-STROKE; ENDOVASCULAR THROMBECTOMY; TIME; SELECTION; WORKFLOW; THERAPY; TRIAL; DOOR;
D O I
10.3174/ajnr.A7716
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: Comprehensive stroke centers continually strive to narrow neurointerventional time metrics. Although process improvements have been put in place to streamline workflows, complex pathways, disparate imaging locations, and fragmented communications all highlight the need for continued improvement. MATERIALS AND METHODS: This Quality Improvement Initiative (VISIION) was implemented to assess our transition to the Viz.ai platform for immediate image review and centralized communication and their effect on key performance indicators in our comprehensive stroke center. We compared periods before and following deployment. Sequential patients having undergone stroke thrombectomy were included. Both direct arriving large-vessel occlusion and Brain Emergency Management Initiative telemedicine transfer large-vessel occlusion cases were assessed as were subgroups of OnHours and OffHours. Text messaging thread counts were compared between time periods to assess communications. Mann-Whitney U and Student t tests were used. RESULTS: Eighty-two neurointerventional cases were analyzed pre vs. post time periods: (DALVO-OnHours 7 versus 7, DALVO-OffHours 10 versus 5, BEMI-OnHours 13 versus 6, BEMI-OffHours 17 versus 17). DALVO-OffHours had a 39% door-to-groin reduction (157 versus 95 minutes, P = .009). DALVO-All showed a 32% reduction (127 versus 86 minutes, P = .006). BEMI-All improved 33% (42 versus 28 minutes, P = .036). Text messaging thread counts improved 30% (39 versus 27, P = .04). CONCLUSIONS: There was an immediate improvement following Viz.ai implementation for both direct arriving and telemedicine transfer thrombectomy cases. In the greatest opportunity subset (direct arriving large-vessel occlusion-OffHours: direct arriving cases requiring team mobilization off-hours), we noted a 39% improvement. With Viz.ai, we noted that immediate access to images and streamlined communications improved door-to-groin time metrics for thrombectomy. These results have implications for future care processes and can be a model for centers striving to optimize workflow and improve thrombectomy timeliness.
引用
收藏
页码:47 / 53
页数:7
相关论文
共 27 条
  • [1] Streamlining door to recanalization processes in endovascular stroke therapy
    Aghaebrahim, Amin
    Streib, Christopher
    Rangaraju, Srikant
    Kenmuir, Cynthia L.
    Giurgiutiu, Dan-Victor
    Horev, Anat
    Saeed, Yumna
    Callaway, Clifton W.
    Guyette, Francis X.
    Martin-Gill, Chris
    Pacella, Charissa
    Ducruet, Andrew F.
    Jankowitz, Brian T.
    Jovin, Tudor G.
    Jadhav, Ashutosh P.
    [J]. JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2017, 9 (04) : 340 - 345
  • [2] Impact of RapidAI mobile application on treatment times in patients with large vessel occlusion
    Al-Kawaz, Mais
    Primiani, Christopher
    Urrutia, Victor
    Hui, Ferdinand
    [J]. JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2022, 14 (03) : 233 - 236
  • [3] Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging
    Albers, G. W.
    Marks, M. P.
    Kemp, S.
    Christensen, S.
    Tsai, J. P.
    Ortega-Gutierrez, S.
    McTaggart, R. A.
    Torbey, M. T.
    Kim-Tenser, M.
    Leslie-Mazwi, T.
    Sarraj, A.
    Kasner, S. E.
    Ansari, S. A.
    Yeatts, S. D.
    Hamilton, S.
    Mlynash, M.
    Heit, J. J.
    Zaharchuk, G.
    Kim, S.
    Carrozzella, J.
    Palesch, Y. Y.
    Demchuk, A. M.
    Bammer, R.
    Lavori, P. W.
    Broderick, J. P.
    Lansberg, M. G.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2018, 378 (08) : 708 - 718
  • [4] Door-to-Needle Times for Tissue Plasminogen Activator Administration and Clinical Outcomes in Acute Ischemic Stroke Before and After a Quality Improvement Initiative
    Fonarow, Gregg C.
    Zhao, Xin
    Smith, Eric E.
    Saver, Jeffrey L.
    Reeves, Mathew J.
    Bhatt, Deepak L.
    Xian, Ying
    Hernandez, Adrian F.
    Peterson, Eric D.
    Schwamm, Lee H.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2014, 311 (16): : 1632 - 1640
  • [5] MR CLEAN, a multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands: study protocol for a randomized controlled trial
    Fransen, Puck S. S.
    Beumer, Debbie
    Berkhemer, Olvert A.
    van den Berg, Lucie A.
    Lingsma, Hester
    van der Lugt, Aad
    van Zwam, Wim H.
    van Oostenbrugge, Robert J.
    Roos, Yvo B. W. E. M.
    Majoie, Charles B.
    Dippel, Diederik W. J.
    [J]. TRIALS, 2014, 15
  • [6] A standardized neurointerventional thrombectomy protocol leads to faster recanalization times
    Frei, Donald
    McGraw, Constance
    McCarthy, Kathryn
    Whaley, Michelle
    Bellon, Richard J.
    Loy, David
    Wagner, Jeff
    Orlando, Alessandro
    Bar-Or, David
    [J]. JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2017, 9 (11) : 1035 - +
  • [7] Main barriers to effective implementation of stroke care pathways in France: a qualitative study
    Gache, Kristel
    Leleu, Henri
    Nitenberg, Gerard
    Woimant, France
    Ferrua, Marie
    Minvielle, Etienne
    [J]. BMC HEALTH SERVICES RESEARCH, 2014, 14
  • [8] Analysis of Workflow and Time to Treatment and the Effects on Outcome in Endovascular Treatment of Acute Ischemic Stroke: Results from the SWIFT PRIME Randomized Controlled Trial
    Goyal, Mayank
    Jadhav, Ashutosh P.
    Bonafe, Alain
    Diener, Hans
    Pereira, Vitor Mendes
    Levy, Elad
    Baxter, Blaise
    Jovin, Tudor
    Jahan, Reza
    Menon, Bijoy K.
    Saver, Jeffrey L.
    [J]. RADIOLOGY, 2016, 279 (03) : 888 - 897
  • [9] Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials
    Goyal, Mayank
    Menon, Bijoy K.
    van Zwam, Wim H.
    Dippel, Diederik W. J.
    Mitchell, Peter J.
    Demchuk, Andrew M.
    Davalos, Antoni
    Majoie, Charles B. L. M.
    van der Lugt, Aad
    de Miquel, Maria A.
    Donnan, Geoff Rey A.
    Roos, Yvo B. W. E. M.
    Bonafe, Alain
    Jahan, Reza
    Diener, Hans-Christoph
    van den Berg, Lucie A.
    Levy, Elad I.
    Berkhemer, Olvert A.
    Pereira, Vitor M.
    Rempel, Jeremy
    Millan, Monica
    Davis, Stephen M.
    Roy, Daniel
    Thornton, John
    San Roman, Luis
    Ribo, Marc
    Beumer, Debbie
    Stouch, Bruce
    Brown, Scott
    Campbell, Bruce C. V.
    van Oostenbrugge, Robert J.
    Saver, Jeff Rey L.
    Hill, Michael D.
    Jovin, Tudor G.
    [J]. LANCET, 2016, 387 (10029) : 1723 - 1731
  • [10] tPA for Stroke Important Progress in Achieving Faster Treatment
    Grotta, James C.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2014, 311 (16): : 1615 - 1617