Bohmann, Ferdinand O., Gruber, Katharina, Kurka, Natalia, Willems, Laurent M., Herrmann, Eva, du Mesnil de Rochemont, Richard, Scholz, Peter, Rai, Heike, Zickler, Philipp, Ertl, Michael, Berlis, Ansgar, Poli, Sven ORCID: 0000-0002-0286-8781, Mengel, Annerose, Ringleb, Peter, Nagel, Simon, Pfaff, Johannes, Wollenweber, Frank A., Kellert, Lars, Herzberg, Moriz, Koehler, Luzie, Haeusler, Karl Georg, Alegiani, Anna, Schubert, Charlotte, Brekenfeld, Caspar, Doppler, Christopher E. J., Onur, Ozgur A., Kabbasch, Christoph, Manser, Tanja, Steinmetz, Helmuth and Pfeilschifter, Waltraud (2022). Simulation-based training improves process times in acute stroke care (STREAM). Eur. J. Neurol., 29 (1). S. 138 - 149. HOBOKEN: WILEY. ISSN 1468-1331

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Abstract

Background The objective of the STREAM Trial was to evaluate the effect of simulation training on process times in acute stroke care. Methods The multicenter prospective interventional STREAM Trial was conducted between 10/2017 and 04/2019 at seven tertiary care neurocenters in Germany with a pre- and post-interventional observation phase. We recorded patient characteristics, acute stroke care process times, stroke team composition and simulation experience for consecutive direct-to-center patients receiving intravenous thrombolysis (IVT) and/or endovascular therapy (EVT). The intervention consisted of a composite intervention centered around stroke-specific in situ simulation training. Primary outcome measure was the 'door-to-needle' time (DTN) for IVT. Secondary outcome measures included process times of EVT and measures taken to streamline the pre-existing treatment algorithm. Results The effect of the STREAM intervention on the process times of all acute stroke operations was neutral. However, secondary analyses showed a DTN reduction of 5 min from 38 min pre-intervention (interquartile range [IQR] 25-43 min) to 33 min (IQR 23-39 min, p = 0.03) post-intervention achieved by simulation-experienced stroke teams. Concerning EVT, we found significantly shorter door-to-groin times in patients who were treated by teams with simulation experience as compared to simulation-naive teams in the post-interventional phase (-21 min, simulation-naive: 95 min, IQR 69-111 vs. simulation-experienced: 74 min, IQR 51-92, p = 0.04). Conclusion An intervention combining workflow refinement and simulation-based stroke team training has the potential to improve process times in acute stroke care.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bohmann, Ferdinand O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gruber, KatharinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kurka, NataliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Willems, Laurent M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herrmann, EvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
du Mesnil de Rochemont, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scholz, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rai, HeikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zickler, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ertl, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berlis, AnsgarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Poli, SvenUNSPECIFIEDorcid.org/0000-0002-0286-8781UNSPECIFIED
Mengel, AnneroseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ringleb, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nagel, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfaff, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wollenweber, Frank A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kellert, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herzberg, MorizUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koehler, LuzieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haeusler, Karl GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alegiani, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schubert, CharlotteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brekenfeld, CasparUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doppler, Christopher E. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Onur, Ozgur A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kabbasch, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Manser, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steinmetz, HelmuthUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfeilschifter, WaltraudUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-603436
DOI: 10.1111/ene.15093
Journal or Publication Title: Eur. J. Neurol.
Volume: 29
Number: 1
Page Range: S. 138 - 149
Date: 2022
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1468-1331
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACUTE ISCHEMIC-STROKE; CREW RESOURCE-MANAGEMENT; TO-NEEDLE TIMES; IMPLEMENTATION; THROMBOLYSIS; OUTCOMES; ALTEPLASE; PROGRAM; IMPACTMultiple languages
Clinical Neurology; NeurosciencesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60343

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