Forward Adam, Sahli Aymane, Kamal Noreen
Department of Industrial Engineering, Faculty of Engineering, Dalhousie University, Halifax, NS B3H 4R2, Canada.
Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada.
Healthcare (Basel). 2024 Sep 25;12(19):1920. doi: 10.3390/healthcare12191920.
(1) Background: Acute ischemic stroke treatment has been thoroughly studied to identify strategies to reduce treatment times. However, many centers still struggle to achieve fast treatment times. Additionally, studies primarily focus on larger, more advanced centers; yet, smaller centers often face longer treatment times. (2) Objectives: The aim of this study is to analyze the existing literature reviewing stroke treatment processes in primary and comprehensive stroke centers that investigated or reduced treatment times. The articles identified were categorized based on the focus areas and approaches used. (3) Results: Three main categories of improvements were identified in the literature: (1) standardization of processes, (2) resource management, and (3) data collection. Both primary and comprehensive stroke centers were able to reduce treatment times through standardization of the processes. However, challenges such as variations in hospital resources and difficulties incorporating data collection software into workflow were highlighted. Additionally, many strategies to optimize resources and data collection that can benefit primary stroke centers were only conducted in comprehensive stroke centers. (4) Conclusions: Many existing strategies to improve stroke treatment times, such as pre-notification and mass stroke team alerts, have been implemented in both primary and comprehensive stroke centers. However, tools such as simulation training are understudied in primary stroke centers and should be analyzed. Additionally, while data collection and feedback are recognized as crucial for process improvement, challenges persist in integrating consistent data collection methods into clinical workflow. Further development of easy-to-use software tailored to clinician needs can help improve stroke center capabilities to provide feedback and improve treatment processes.
(1) 背景：急性缺血性中风治疗已得到深入研究，以确定缩短治疗时间的策略。然而，许多中心仍在努力实现快速治疗时间。此外，研究主要集中在规模较大、更先进的中心；而较小的中心往往面临更长的治疗时间。(2) 目的：本研究的目的是分析现有文献，回顾在初级和综合中风中心研究或缩短治疗时间的中风治疗过程。所确定的文章根据重点领域和使用的方法进行分类。(3) 结果：文献中确定了三类主要改进：(1) 流程标准化，(2) 资源管理，(3) 数据收集。初级和综合中风中心都能够通过流程标准化来缩短治疗时间。然而，也突出了一些挑战，如医院资源的差异以及将数据收集软件纳入工作流程的困难。此外，许多优化资源和数据收集的策略，虽然对初级中风中心有益，但仅在综合中风中心实施。(4) 结论：许多现有的改善中风治疗时间的策略，如预先通知和大规模中风团队警报，已在初级和综合中风中心实施。然而，模拟训练等工具在初级中风中心的研究较少，应进行分析。此外，虽然数据收集和反馈被认为对流程改进至关重要，但在将一致的数据收集方法整合到临床工作流程方面仍存在挑战。进一步开发适合临床医生需求的易用软件，有助于提高中风中心提供反馈和改善治疗流程的能力。
