Simulation-based training improves process times in acute stroke care (STREAM)
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Simulation-based training improves process times in acute stroke care (STREAM). / Bohmann, Ferdinand O; Gruber, Katharina; Kurka, Natalia; Willems, Laurent M; Herrmann, Eva; du Mesnil de Rochemont, Richard; Scholz, Peter; Rai, Heike; Zickler, Philipp; Ertl, Michael; Berlis, Ansgar; Poli, Sven; Mengel, Annerose; Ringleb, Peter; Nagel, Simon; Pfaff, Johannes; Wollenweber, Frank A; Kellert, Lars; Herzberg, Moriz; Koehler, Luzie; Haeusler, Karl Georg; Alegiani, Anna; Schubert, Charlotte; Brekenfeld, Caspar; Doppler, Christopher E J; Onur, Özgür A; Kabbasch, Christoph; Manser, Tanja; Steinmetz, Helmuth; Pfeilschifter, Waltraud; STREAM Trial Investigators.
In: EUR J NEUROL, Vol. 29, No. 1, 01.2022, p. 138-148.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Simulation-based training improves process times in acute stroke care (STREAM)
AU - Bohmann, Ferdinand O
AU - Gruber, Katharina
AU - Kurka, Natalia
AU - Willems, Laurent M
AU - Herrmann, Eva
AU - du Mesnil de Rochemont, Richard
AU - Scholz, Peter
AU - Rai, Heike
AU - Zickler, Philipp
AU - Ertl, Michael
AU - Berlis, Ansgar
AU - Poli, Sven
AU - Mengel, Annerose
AU - Ringleb, Peter
AU - Nagel, Simon
AU - Pfaff, Johannes
AU - Wollenweber, Frank A
AU - Kellert, Lars
AU - Herzberg, Moriz
AU - Koehler, Luzie
AU - Haeusler, Karl Georg
AU - Alegiani, Anna
AU - Schubert, Charlotte
AU - Brekenfeld, Caspar
AU - Doppler, Christopher E J
AU - Onur, Özgür A
AU - Kabbasch, Christoph
AU - Manser, Tanja
AU - Steinmetz, Helmuth
AU - Pfeilschifter, Waltraud
AU - STREAM Trial Investigators
N1 - © 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2022/1
Y1 - 2022/1
N2 - BACKGROUND: The objective of the STREAM Trial was to evaluate the effect of simulation training on process times in acute stroke care.METHODS: The multicenter prospective interventional STREAM Trial was conducted between 10/2017 and 04/2019 at seven tertiary care neurocenters in Germany with a pre- and post-interventional observation phase. We recorded patient characteristics, acute stroke care process times, stroke team composition and simulation experience for consecutive direct-to-center patients receiving intravenous thrombolysis (IVT) and/or endovascular therapy (EVT). The intervention consisted of a composite intervention centered around stroke-specific in situ simulation training. Primary outcome measure was the 'door-to-needle' time (DTN) for IVT. Secondary outcome measures included process times of EVT and measures taken to streamline the pre-existing treatment algorithm.RESULTS: The effect of the STREAM intervention on the process times of all acute stroke operations was neutral. However, secondary analyses showed a DTN reduction of 5 min from 38 min pre-intervention (interquartile range [IQR] 25-43 min) to 33 min (IQR 23-39 min, p = 0.03) post-intervention achieved by simulation-experienced stroke teams. Concerning EVT, we found significantly shorter door-to-groin times in patients who were treated by teams with simulation experience as compared to simulation-naive teams in the post-interventional phase (-21 min, simulation-naive: 95 min, IQR 69-111 vs. simulation-experienced: 74 min, IQR 51-92, p = 0.04).CONCLUSION: An intervention combining workflow refinement and simulation-based stroke team training has the potential to improve process times in acute stroke care.
AB - BACKGROUND: The objective of the STREAM Trial was to evaluate the effect of simulation training on process times in acute stroke care.METHODS: The multicenter prospective interventional STREAM Trial was conducted between 10/2017 and 04/2019 at seven tertiary care neurocenters in Germany with a pre- and post-interventional observation phase. We recorded patient characteristics, acute stroke care process times, stroke team composition and simulation experience for consecutive direct-to-center patients receiving intravenous thrombolysis (IVT) and/or endovascular therapy (EVT). The intervention consisted of a composite intervention centered around stroke-specific in situ simulation training. Primary outcome measure was the 'door-to-needle' time (DTN) for IVT. Secondary outcome measures included process times of EVT and measures taken to streamline the pre-existing treatment algorithm.RESULTS: The effect of the STREAM intervention on the process times of all acute stroke operations was neutral. However, secondary analyses showed a DTN reduction of 5 min from 38 min pre-intervention (interquartile range [IQR] 25-43 min) to 33 min (IQR 23-39 min, p = 0.03) post-intervention achieved by simulation-experienced stroke teams. Concerning EVT, we found significantly shorter door-to-groin times in patients who were treated by teams with simulation experience as compared to simulation-naive teams in the post-interventional phase (-21 min, simulation-naive: 95 min, IQR 69-111 vs. simulation-experienced: 74 min, IQR 51-92, p = 0.04).CONCLUSION: An intervention combining workflow refinement and simulation-based stroke team training has the potential to improve process times in acute stroke care.
U2 - 10.1111/ene.15093
DO - 10.1111/ene.15093
M3 - SCORING: Journal article
C2 - 34478596
VL - 29
SP - 138
EP - 148
JO - EUR J NEUROL
JF - EUR J NEUROL
SN - 1351-5101
IS - 1
ER -