CHI St. Anthony Hospital was recently recognized as having the best median door to CT time in the Providence Stroke Network, which includes 22 hospitals throughout the state of Oregon. This award was made possible by the excellent collaboration between our EMS, ED nursing staff, and Diagnostic Imaging Staff. Recently, we sat down with Tracy Holliday RN, stroke coordinator for St. Anthony Hospital, to learn more about her position and the stroke program at St. Anthony.
Q: What is your role as the Stroke Coordinator?
A: The role of the stroke coordinator is to keep our protocols up to date and in line with the American Heart Association (AHA) stroke registry, assist Providence hospital with patient/treatment information, educate staff on the current standards of care for stroke patients, and keep stroke policy up to date with current national standards.
Q: What are some things we do to improve our stroke program, especially the door to CT time?
A: We continually update the policy in our hospital to meet national standards as determined by AHA. We adjusted our practice by developing a team approach to facilitate timely treatment of every patient. For example, each member of the health care team in the ER assumes a role when a suspected stroke patient arrives. We call an ER team, which is announced overhead, to bring the different departments/members of the care team to the patient (imaging, lab, available nursing staff). When a patient with stroke symptoms is coming in via ambulance, we leave the patient on the stretcher and go straight to CT to meet AHA standards of care.
Q: Has our door to CT time always been good, or have we improved recently?
A: I have been the coordinator for 2 years. Before then, we did not have any set standards/practice to expedite the patient-to-CT process for the early detection of a stroke diagnosis and treatment. Recently our door-to-CT time is less than 3 minutes. We do not know previous times of door-to-CT, however, our care team members should pride themselves on our current time as this is an accomplishment as a facility.
Q: How do we collaborate with other agencies to make a good stroke program?
A: We collaborate with EMS for early notification of stroke symptoms with EMS completing a FAST exam prior to the patient arriving in our ER. This allows us to alert radiology that a patient is coming into the ER. Radiology starts warming up the CT machine in preparation of receiving the patient as quickly as possible. The CT report is sent electronically through Telestroke to Providence, which is promptly read by a neurologist.
Q: Anything else you'd like to add?
A: Key parts in the timely treatment for our stroke patients are working with EMS on early notification of stroke symptoms, working with the radiology department to prepare for receiving the patient straight from the door-to-CT, and ER staff members assuming roles when the patient arrives.
At St. Anthony Hospital, we are committed to giving the best patient care possible, and this award affirms our efforts in providing the best standard of care for our Stroke patients. Great job, St. Anthony Team!