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A computerized in-hospital alert system for thrombolysis in acute stroke
- A computerized in-hospital alert system for thrombolysis in acute stroke
- Heo J.H.; Kim Y.D.; Nam H.S.; Hong K.-S.; Ahn S.H.; Cho H.J.; Choi H.-Y.; Han S.W.; Cha M.-J.; Hong J.M.; Kim G.-M.; Kim G.S.; Kim H.J.; Kim S.H.; Kim Y.-J.; Kwon S.U.; Lee B.-C.; Lee J.H.; Lee K.H.; Oh M.S.
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- Stroke vol. 41, no. 9, pp. 1978 - 1983
- SCIE; SCOPUS
- Document Type
- Background and Purpose-: An effective stroke code system that can expedite rapid thrombolytic treatment requires effective notification/communication and an organized team approach. We developed a stroke code program based on the computerized physician order entry (CPOE) system and investigated whether implementation of this CPOE-based program is useful for reducing the time from arrival at emergency departments (ED) to evaluation steps and the initiation of thrombolytic treatment in various hospital settings. Methods-: The CPOE-based program was implemented by 10 hospitals. Time intervals from arrival at the ED to blood tests, computed tomography scanning, and thrombolytic treatment during the 1-year period before and the 1-year period after the program implementation were compared. Results-: Time intervals from ED arrival to evaluation steps were significantly reduced after implementation of the CPOE-based program. Times from ED arrival to CT scan, complete blood counts, and prothrombin time testing were reduced by 7.7 minutes, 5.6 minutes, and 26.8 minutes, respectively (P<0.001). The time from ED arrival to intravenous thrombolysis was reduced from 71.7±33.6 minutes to 56.6±26.9 minutes (P<0.001). The number of patients who were treated with thrombolysis increased from 3.4% (199/5798 patients) before the CPOE-based program to 5.8% (312/5405 patients) afterward (P<0.001). The CPOE implementation also improved the inverse relationship between onset-to-door time and door-to-needle time. Conclusions-: The CPOE-based stroke code could be successfully implemented to reduce in-hospital time delay in thrombolytic therapy in various hospital settings. CPOE may be used as an efficient tool to facilitate in-hospital notification/communication and an organized team approach. © 2010 American Heart Association, Inc.
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