欧美极品 — Washington, D.C., May 13, 2015 鈥 Using efficiency principles borrowed from 鈥渓ean鈥 manufacturing processes, two Washington-area hospitals have gotten a life-saving drug to stroke patients significantly quicker, while also obtaining better diagnostic information using MRI. That鈥檚 according to a new study published online ahead of print in the May 13 issue of , the medical journal of the .

National benchmarks call for getting stroke patients from the door of the emergency room to injection with the clot-busting drug known as intravenous tissue plasminogen activator, or IV tPA in 60 minutes or less because the sooner tPA is administered, the better the outcome. But before the drug can be administered, patients must receive either a CT or MRI scan, to determine whether they are suitable candidates for the drug treatment. While an MRI can provide more valuable diagnostic information, it takes longer than a CT scan. So, few hospitals in the country routinely use an MRI as first-line brain imaging for acute stroke patients.

However, teams at and Suburban Hospital in Bethesda, Md., found that by analyzing and changing their work processes, they could reduce 鈥渄oor-to-needle鈥 times from 93 to 55 minutes, a 40 percent difference and meet the benchmark of 60 minutes or less while using MRI for first-line brain imaging, according to the study鈥檚 physicians. This research was supported by the NIH鈥檚 National Institute of Neurological Disorders and Stroke.

鈥淯sing MRI scans gives doctors valuable information to help make treatment decisions, including the location and size of the stroke if present, when it occurred, the extent of blood vessel blockage and amount of brain tissue at risk, new or old bleeding, and potentially the cause of the stroke,鈥 said , medical director of the Comprehensive Stroke Center at MedStar Washington Hospital Center, and the study鈥檚 senior author. 鈥淲e borrowed ideas from manufacturers who use 鈥榣ean鈥 production processes to make their plants more efficient, and applied them to healthcare. Our colleagues at Washington University in St. Louis had previously applied these principles to the evaluation of stroke with CT, which inspired us to take a similar approach with MRI.鈥 A critical factor in improving efficiency is teamwork among all the different areas involved in evaluating stroke patients, including emergency room physicians, nurses and technicians; radiology and laboratory staff; and acute stroke team physicians and nurses.

鈥淲e wanted to share with other hospitals exactly how we streamlined our processes so they could see what鈥檚 possible, and consider applying similar interventions within their own institutions, to be able to use MRI scans when needed to quickly guide treatment decisions for patients with suspected stroke,鈥 added Dr. Hsia.

Among the efficiency-improving steps taken by the hospitals were creating process maps to identify roadblocks causing delays, reorganizing the work flow to reduce handoffs, and assigning specific roles to each member of the stroke team. The study鈥檚 authors concluded that by using these approaches, other hospitals could reduce their door-to-needle times as well, and begin using MRI scans. The time-saving techniques are known as SMART, or Screening with MRI for Accurate and Rapid stroke Treatment.

In addition, according to Dr. Hsia, many of these interventions can also be applied to hospitals that primarily use screening CT scans, because they affect the processes before and after the brain scan rather than the imaging itself.

MedStar Washington Hospital Center is the first and only hospital in the Washington region to be certified as a by The Joint Commission. The Hospital Center is one of only 73 medical centers nationwide to receive this prestigious designation, which indicates that a hospital offers the highest level of care for patients with the most severe and challenging types of strokes and cerebrovascular disease.

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MedStar Washington Hospital Center is a 926-bed, major teaching and research hospital. It is the largest private, not-for-profit hospital in the nation鈥檚 capital, among the 100 largest hospitals in the nation and a major referral center for treating the most complex cases. U.S.欧美极品 & World Report consistently ranks the hospital鈥檚 cardiology and heart surgery program as one of the nation鈥檚 best. It also is a respected top facility in the areas of cancer, diabetes & endocrinology, Ear, Nose & Throat, gastroenterology & GI surgery, geriatrics, gynecology, nephrology, pulmonology and urology. It operates MedSTAR, a nationally-verified level I trauma center with a state-of-the-art fleet of helicopters and ambulances, and also operates the region鈥檚 only adult Burn Center.