TY  - JOUR
A1  - Bohmann, Ferdinand
A1  - Gruber, Katharina
A1  - Kurka, Natalia
A1  - Willems, Laurent Maximilian
A1  - Herrmann, Eva
A1  - Du Mesnil de Rochemont, Richard Klaus Frieder
A1  - Scholz, Peter
A1  - Rai, Heike
A1  - Zickler, Philipp Patrick
A1  - Ertl, Michael
A1  - Berlis, Ansgar
A1  - Poli, Sven
A1  - Mengel, Annerose
A1  - Ringleb, Peter A.
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  - Steinmetz, Helmuth
A1  - Pfeilschifter, Waltraud
T1  - Simulation-based training improves process times in acute stroke care (STREAM)
T2  - European journal of neurology
N2  - 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.
KW  - CRM
KW  - simulation
KW  - stroke
KW  - thrombolysis
KW  - training
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/74630
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-746304
SN  - 1468-1331
N1  - The study was funded by Stryker Neurovascular (grant to W.P.). The funding source was not involved in study design, monitoring, data collection, statistical analyses, interpretation of results, or manuscript writing, Open Access funding enabled and organized by Projekt DEAL. WOA Institution: Goethe-Universitat Frankfurt am Main Blended DEAL: Projekt DEAL.
VL  - 29
IS  - 1
SP  - 138
EP  - 148
PB  - Wiley-Blackwell
CY  - Oxford [u.a.]
ER  -