Authors (including presenting author) :
Kwok WYV(1) Lau Alex(2), Fong WC(2), Lo WT (1), Chau SK(1), Or HF(1), Chan ST(1), Fong CS(1),Poon WL(3), Poon TL(4)
Affiliation :
1 Department of Medicine (Neurology)
2 Kowloon Central Cluster information Technology Divison
3 Diagnostic & Interventional Radiology
4 Department of Neurosurgery
Introduction :
The development of acute stroke service is critical for improving patient outcomes following stroke. Queen Elizabeth hospital (QEH) has implemented 24/7 intravenous (IV) thrombolysis service for ischaemic strokes since 2008.
For patients with strokes due to large vessel occlusions (LVO), studies have shown that mechanical thrombectomy significantly improve the function outcome when compared to IV thrombolysis alone. Moreover, for LVO patients contraindicated for IV thrombolysis due to coexisting conditions, mechanical thrombectomy may be the only feasible option. Mechanical thrombectomy services involves a more complicated workflow and input from more disciplines. QEH has developed mechanical thrombectomy services for QEH and UCH patients since 2021, with good collaboration between the AED, DIR, Medical and Neurosurgery (NS) Departments.
Objectives :
Both IV thrombolysis and mechanical thrombectomy are time-critical hyperacute stroke treatments, effective communication among different team members is important. To facilitate communication, the Stroke Nursing team of Queen Elizabeth hospital, with the support of Kowloon Central Cluster Information Technology Division, has developed the Stroke Smart Call and data all-in-one system. In the past, during hyperacute stroke call for patient presenting within the therapeutic time window, stroke nurses must use phone call to communicate with different team members including neuro-interventionists, radiographers in the computed tomography (CT) suite and in the angiography suite, DIR nurse and NS high-dependency unit (HDU) nurse. The new Smart call system enables efficient communication of the assessment of mechanical thrombectomy treatment eligibility of QEH and UCH patients. This system also helps communication during patient transfer between the two hospitals.
Methodology :
Stroke Smart Call and data all-in-one system(Smart Call) Version 1.0 was launched in 2021. Stroke nurses enter patients’ information including the ID number, symptom onset time, stroke severity scoring (National Institutes of Health Stroke Scale NIHSS) into the Smart system. All thrombectomy team members would be notified of the patients’ information immediately and simultaneously via HA chat. By using the system, miscommunication of clinical information can be avoided. Phone calls are minimized and time saved.
The Smart Call 2.0 version is an enhanced version with the additional feature of an interactive button on HA chat. The interface is designed to be intuitive and simple to use on the phone. Stroke team members can acknowledge important information once received, and communicate the readiness of different locations and personnel involved. The closed loop communication is important especially with increasing workload.
Result & Outcome :
By comparing to conventional method, using smart Stroke communication system make timely communication which would allow different team members to prepare and act promptly as well as shortening the time to treatment.
The development of the Stroke Smart Call System is crucial for enhancing the efficiency and effectiveness of stroke care. Looking forward, with the help of IT team, we aim to create real-time tracking of patient location, and a database that includes patients’ information, call data, time metrics and treatment outcomes. These would facilitate the team to use data analytics to assess time performance, identify trends in stroke call activation as well as treatment outcome. It could potentially lead to better patients’ functional outcome after stroke.
