Impact of a Standardized Alarming System on Treatment Times and Workflow in Stroke Patients With Interhospital Transfer for Thrombectomy

Study Overview
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Brief Summary
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The aim of this study is to evaluate the impact of a standardized alarming system on treatment times and workflow in stroke patients with interhospital transfer for mechanical thrombectomy (MT). The main questions it aims to answer are: Is the implementation of a standardized alarming system associated with shorter transfer and treatment times? Is the implementation of a standardized alarming system associated with a better adherence on existing standard operating procedures for interhospital transfer? We will analyze data from our existing thrombectomy registry comparing time periods before and after introduction of the MT alarming system.

Official Title
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Impact of a Standardized Alarming System on Treatment Times and Workflow in Stroke Patients With Interhospital Transfer for Thrombectomy

Conditions
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Acute Ischemic Stroke

Intervention / Treatment
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* Other: standardized MT alarming system


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age >= 18 years diagnosis of acute ischemic stroke indication for mechanical thrombectomy admission to one of 7 participating primary stroke centers within in the catchment area of the referral center Exclusion Criteria: unclear indication for mechanical thrombectomy (patients admitted for perfusion imaging before decision for or against a MT)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| pre implementation period<br>stroke patients transferred within the 6 months before introduction of the alarming system | |
| implementation period<br>stroke patients transferred within the 6 months after introduction of the alarming system | Other: standardized MT alarming system<br>* Standardized alarming system via telephone loop in the primary thrombectomy centre triggered immediately after decision to mechanical thrombectomy in stroke patients admitted in primary stroke centers<br>|
| post implementation period<br>stroke patients transferred within the 6-12 months after introduction of the alarming system | Other: standardized MT alarming system<br>* Standardized alarming system via telephone loop in the primary thrombectomy centre triggered immediately after decision to mechanical thrombectomy in stroke patients admitted in primary stroke centers<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| decision-to-groin time | time from decision for MT (while patient still in the primary stroke center) to groin puncture (start of mechanical thrombectomy procedure in the primary thrombectomy center) | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| decision-to-departure time | time from decision for MT to departure of the patient from primary stroke center (to the primary thrombectomy center) | 24 hours | 
| decision-to-arrival time | time from decision for MT to arrival of the patient at the primary thrombectomy center | 24 hours | 
| arrival-to-groin time | time from arrival of the patient at the primary thrombectomy center to groin puncture (start of mechanical thrombectomy procedure) | 24 hours | 
| rate of refusal of transfer requests due to lack of capacity | rate of patients that had to be transferred to a secondary thrombectomy center instead of the primary thrombectomy centre due to lack of capacity in the referral clinic | 24 hours | 
| decision-to-transfer request time | Time from decision for MT to request of emergency medical service for interhospital transfer | 24 hours | 
| Periprocedural complications | rate of periprocedural complications during MT | 24 hours | 
| Successful outcome of MT (mTICI > 2b) | rate of successfully performed MT (mTICI > 2b) of all patients with attempted MT | 24 hours | 
| groin-to-recanalization time | Time from groin puncture to successful recanalization | 24 hours | 
| Adverse events within 7 days | Adverse events within the first 7 days after transfer to referral center | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mechanical thrombectomy, telestroke, drip and ship, interhospital transfer, communication