Wide Variations Seen in Workforce Processes Before Mechanical Thrombectomy

July 27, 2016—The Society of NeuroInterventional Surgery (SNIS) announced that findings from a new study show that there are wide variations among institutions in workflow processes related to triage, team activation, transport, and case preparation for the neurointerventional treatment of stroke via mechanical thrombectomy.

The study, “Planning for Efficiency: Survey of Technical and Workflow Practices before Mechanical Thrombectomy,” was presented at the SNIS 13th Annual Meeting in Boston, Massachusetts. Its lead author is Akash Kansagra, MD.

According to SNIS, the study revealed that broader dissemination of best practices and successful workflows may allow institutions to develop more efficient systems of care that could help save more lives.

The investigators found that 86% of institutions contacted the neurointerventional physician before the presence of a treatable stroke was confirmed. However, only 43% of institutions allowed the time-saving step of moving the patient to the procedure room while the neurointerventional team was en route to the hospital. 

Additional findings include more than half of hospitals designate nonphysician staff, such as a designated stroke nurse familiar with relevant care protocols, to respond to stroke codes with the express purpose of coordinating rapid triage in the emergency department, two-thirds of hospitals are able to routinely utilize anesthesiologists to provide support during thrombectomies, and most hospitals have a mandated response time for neurointerventional team members (most commonly 30 minutes).

“Mechanical thrombectomy has proven benefit in selected patients with acute ischemic stroke, but the degree of benefit depends on how quickly thrombectomy can be successfully performed. Systems need to evolve so that appropriate patients can undergo thrombectomy in a timely fashion,” commented Dr. Kansagra in the SNIS announcement. Dr. Kansagra is Assistant Professor of Radiology at Washington University School of Medicine and serves as Medical Director of the Endovascular Acute Stroke Committee at Barnes-Jewish Hospital in St. Louis, Missouri.