title: Stop Stroke© Acute Care Coordination Medical Application: A Brief Report on Postimplementation Performance at a Primary Stroke Center.
abstract: BACKGROUND
  The objective of our study was to evaluate the effect of the Pulsara Stop Stroke© medical application on door-to-needle (DTN) time in patients presenting to our emergency department with acute ischemic stroke (AIS). The secondary objective was to evaluate the DTN performance of dedicated neurohospitalists versus private practice neurologists covering emergency department stroke call.
  
  
  METHODS
  We conducted a retrospective cohort study of the Good Shepherd Health System stroke quality improvement dashboard for an 18-month period. The primary outcome was mean DTN time performance in cases with and without Stop Stroke© usage. Secondary outcome was mean DTN time between neurohospitalist and private neurologists with and without use of Stop Stroke©.
  
  
  RESULTS
  During the study period, there were 85 stroke activations receiving tissue plasminogen activator (63 with Stop Stroke©, 22 without Stop Stroke©). In cases where the app was used, we observed a reduction in mean DTN time of 40 minutes (87-47 minutes), a 46% reduction. There was no significant difference in DTN time observed between the neurohospitalist and private neurologist performance independent of app usage. Mean DTN less than 60 minutes improved with app use from 18% to 85% with Stop Stroke©.
  
  
  CONCLUSIONS
  In patients arriving to our primary stroke center with AIS, use of Pulsara Stop Stroke© acute care coordination app decreased mean DTN time by 40 minutes, a significant 46% improvement in this metric and is consistent with other studies of the app. We further observed a 3.7× improvement in DTN less than 60 minutes with use of the app.
authors.affiliation: Baylor College of Medicine, Houston, Texas. Electronic address: Rob.dickson@mchd-tx.org.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Dickson
authors.affiliation: Palmerston North Hospital, Palmerston North, New Zealand.
authors.forename: Dineth
authors.initials: D
authors.lastname: Sumathipala
authors.affiliation: Good Shepherd Medical Center, Longview, Texas.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reeves
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D033183:Interdisciplinary Communication; D063731:Mobile Applications; D010348:Patient Care Team / Q000458:organization & administration*; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration; D019984:Quality Indicators, Health Care / Q000458:organization & administration; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy*; D013781:Texas; D015912:Thrombolytic Therapy; D013997:Time Factors; D061665:Time-to-Treatment / Q000458:organization & administration*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Stroke; acute care coordination; emergency medical service; medical application; therapy; time to therapy; tissue plasminogen activator