The WVU Stroke Center Acute Stroke Team saw a significant improvement of their IV tissue plasminogen activator (t-PA) treatment times for acute ischemic stroke patients in 2015.

Internal data shows that the average IV t-PA door-to-needle (DTN) times dropped from 61.1 minutes in the second quarter to 42.8 minutes in the fourth quarter. That is an improvement of 18.3 minutes, on average, for DTN treatment times

“It takes an enormous coordinated effort across the entire spectrum of care to put the processes and infrastructure in place to achieve this kind of success,” said Angela Schaffer, a clinical nurse specialist at the WVU Stroke Center. “This includes educating the public on recognizing stroke and 911 activation, and all the providers and staff who subsequently respond.”

Schaffer says that the providers and staff involved include prehospital personnel; emergency department and resource pool staff; neurology service and stroke program staff; laboratory, radiology and pharmacy staff; and those who later abstract, validate and analyze the data for research, quality and continued process improvement.

IV t-PA, also called the “clot-buster” medicine, has long been considered the standard of care for the treatment of eligible patients suffering from acute ischemic stroke. In order for the treatment to be safe and most effective, it must be administered within a three-hour window from onset of stroke symptoms with a guideline-recommended DTN time of 60 minutes or less for hospitals providing the treatment.

“We are very fortunate to have a team this engaged,” said Leslie Harclerode, administrative director of the WVU Stroke Center. “These times translate to better outcomes for our patients.” 

Studies have shown that a reduction in DTN times is accompanied by lower in-hospital mortality, lower rates of intracranial hemorrhagic transformation (bleeding in the brain), fewer complications overall, and increased discharges to home with greater independence.

WVU Medicine-WVU Hospitals averaged DTN times of 48.3 minutes compared to a national average of 60.4 minutes when benchmarked against other certified primary stroke centers across the country participating in the American Heart Association/American Stroke Association’s Get With the Guidelines program.

“There is an excitement here about treating stroke, which has led to better times,” said Matthew Smith, M.D., director of neurocritical care in the WVU Department of Neurology. “WVU has been charged with being a leader in stroke care for this area, and we are working hard to answer that call.”

The WVU Stroke Center team members celebrated their improved treatment times with a breakfast on January 13.