Mobile stroke unit teams become more efficient and effective over time. That’s the implication of an analysis of Cleveland Clinic’s experience with its mobile stroke unit (MSU) over the three and a half years since its launch in July 2014 as one of the nation’s first such specialized ambulances for patients with suspected acute stroke.
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The analysis, presented at the 2018 International Stroke Conference in Los Angeles, compares care process measures between the first 100 patients evaluated on the MSU in 2014 and 100 consecutive patients evaluated on the MSU in mid-2017. The groups were comparable in age and initial median NIH Stroke Scale score, and thrombolysis was used in 16 percent of patients in both cohorts.
Despite these similarities, care was consistently delivered more swiftly in the 2017 cohort, with statistically significant reductions from 2014 in median door-to-needle time, door-to-CT completion/read times, alarm-to-thrombolysis time and other measures. For example, median door-to-needle time dropped from 31 minutes in 2014 to 23 minutes in 2017 — a 26 percent improvement.
Coinvestigator Andrew Russman, DO, puts the study in context in the short video below, with some insights for others considering or launching MSUs of their own.