title: Door to thrombolysis: ER reorganization and reduced delays to acute stroke treatment.
abstract: The authors reorganized the emergency room (ER) by moving CT to the ER and streamlining triage by prenotification by emergency medical services (EMS), which reduced in-hospital delays and enhanced access to stroke thrombolysis. CT delay dropped from 1 hour 3 minutes +/- 14 minutes in 1999 to 7 +/- 2 minutes in 2004 (p < 0.0001). Door-to-needle time dropped from 1 hour 28 minutes +/- 7 minutes to 50 +/- 3 minutes (p < 0.001), while symptom-to-needle time dropped from 2 hours 44 minutes +/- 6 minutes to 2 hours 5 minutes +/- 4 minutes (p < 0.0001). From 23 patients in 1999, thrombolysis access was increased to 100 patients in 2004 and 183 patients in 2005.
authors.affiliation: Emergency Neurology Services, Department of Neurology, Biomedicum Helsinki,Helsinki, Finland. perttu.lindsberg@hus.fi
authors.forename: P J
authors.initials: PJ
authors.lastname: Lindsberg
authors.forename: O
authors.initials: O
authors.lastname: Häppölä
authors.forename: M
authors.initials: M
authors.lastname: Kallela
authors.forename: L
authors.initials: L
authors.lastname: Valanne
authors.forename: M
authors.initials: M
authors.lastname: Kuisma
authors.forename: M
authors.initials: M
authors.lastname: Kaste
mesh_terms: D000208:Acute Disease; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005387:Finland / Q000453:epidemiology; D006754:Hospital Restructuring / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D017748:Time Management / Q000458:organization & administration*; D014218:Triage / Q000458:organization & administration*