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A computerized in-hospital alert system for thrombolysis in acute stroke

Title
A computerized in-hospital alert system for thrombolysis in acute stroke
Authors
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
김용재
SCOPUS Author ID
김용재scopus
Issue Date
2010
Journal Title
Stroke
ISSN
0039-2499JCR Link
Citation
vol. 41, no. 9, pp. 1978 - 1983
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
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.
DOI
10.1161/STROKEAHA.110.583591
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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