TY  - JOUR
A1  - Bohmann, Ferdinand
A1  - Kurka, Natalia
A1  - Du Mesnil de Rochemont, Richard Klaus Frieder
A1  - Gruber, Katharina
A1  - Guenther, Joachim
A1  - Rostek, Peter
A1  - Rai, Heike
A1  - Zickler, Philipp
A1  - Ertl, Michael
A1  - Berlis, Ansgar
A1  - Poli, Sven
A1  - Mengel, Annerose
A1  - Ringleb, Peter
A1  - Nagel, Simon
A1  - Pfaff, Johannes
A1  - Wollenweber, Frank Arne
A1  - Kellert, Lars
A1  - Herzberg, Moriz
A1  - Köhler, Luzie Katharina
A1  - Häusler, Karl Georg
A1  - Alegiani, Anna
A1  - Schubert, Charlotte
A1  - Brekenfeld, Caspar
A1  - Doppler, Christopher Emanuel Julian
A1  - Onur, Özgür Abdullah
A1  - Kabbasch, Christoph
A1  - Manser, Tanja
A1  - Pfeilschifter, Waltraud
T1  - Simulation-based training of the rapid evaluation and management of acute stroke (stream) - a prospective single-arm multicenter trial
T2  - Frontiers in neurology
N2  - Introduction: Acute stroke care delivered by interdisciplinary teams is time-sensitive. Simulation-based team training is a promising tool to improve team performance in medical operations. It has the potential to improve process times, team communication, patient safety, and staff satisfaction. We aim to assess whether a multi-level approach consisting of a stringent workflow revision based on peer-to-peer review and 2–3 one-day in situ simulation trainings can improve acute stroke care processing times in high volume neurocenters within a 6 months period.
Methods and Analysis: The trial is being carried out in a pre-test-post-test design at 7 tertiary care university hospital neurocenters in Germany. The intervention is directed at the interdisciplinary multiprofessional stroke teams. Before and after the intervention, process times of all direct-to-center stroke patients receiving IV thrombolysis (IVT) and/or endovascular therapy (EVT) will be recorded. The primary outcome measure will be the “door-to-needle” time of all consecutive stroke patients directly admitted to the neurocenters who receive IVT. Secondary outcome measures will be intervention-related process times of the fraction of patients undergoing EVT and effects on team communication, perceived patient safety, and staff satisfaction via a staff questionnaire.
Interventions: We are applying a multi-level intervention in cooperation with three “STREAM multipliers” from each center. First step is a central meeting of the multipliers at the sponsor's institution with the purposes of algorithm review in a peer-to-peer process that is recorded in a protocol and an introduction to the principles of simulation training and debriefing as well as crew resource management and team communication. Thereafter, the multipliers cooperate with the stroke team trainers from the sponsor's institution to plan and execute 2–3 one-day simulation courses in situ in the emergency department and CT room of the trial centers whereupon they receive teaching materials to perpetuate the trainings.
Clinical Trial Registration: STREAM is a registered trial at https://clinicaltrials.gov/ct2/show/NCT03228251.
KW  - CRM
KW  - thrombolysis (tPA)
KW  - stroke
KW  - emergency care
KW  - simulation training
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/51116
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-511163
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2019.00969
SN  - 1664-2295
N1  - Copyright © 2019 Bohmann, Kurka, du Mesnil de Rochemont, Gruber, Guenther, Rostek, Rai, Zickler, Ertl, Berlis, Poli, Mengel, Ringleb, Nagel, Pfaff, Wollenweber, Kellert, Herzberg, Koehler, Haeusler, Alegiani, Schubert, Brekenfeld, Doppler, Onur, Kabbasch, Manser, Pfeilschifter and STREAM Trial Investigators. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
VL  - 10
IS  - Art. 969
SP  - 1
EP  - 9
PB  - Frontiers Research Foundation
CY  - Lausanne
ER  -