THE IMPLEMENTATION OF THE CODE STROKE PIT STOP: A QUALITY IMPROVEMENT PROJECT FOR GREATER EFFICIENCY

Despite recent medical advancements to reduce the devastating morbidity and mortality outcomes commonly associated with ischemic stroke, there remains a disparity in access to these lifesaving interventions. The benefits of these advanced stroke interventions are profound and proven by the robust evidence in landmark studies conducted at high-performing academic medical institutions. However, the literature shows these interventions improve clinical outcomes when implemented by highly efficient systems-based processes. The code stroke process is the emergency department (ED) response system for acute stroke patients and the target area for streamlining quality improvement for efficient throughput to the appropriate intervention. This doctoral project aims to improve the efficiency of the stroke response process in the community hospital setting. The STAR module was applied to bridge the evidence into practice and nurture the needed cultural shift at the 377-bed community hospital. The optimized workflow was developed using the best evidence and shared experiences, and 12 ED quality/stroke nurses and approximately 60 ED staff nurses were trained. After implementing the optimized code stroke process, the desired outcomes were improved standard benchmark stroke performance data. The outcome performance data revealed overall improvement in performance and clinically significant improvement in stroke intervention performance. The successful implementation of an innovative code stroke process, called the code stroke pit stop, yields an opportunity to help drive improvement efforts at the community hospital setting seeking to advance the stroke program.