title: Participation in a Tele-Stroke Program Improves Timeliness of Intravenous Thrombolysis Delivery.
abstract: We sought to assess the effects of participation in a tele-stroke program on timeliness of intravenous tissue plasminogen activator (IVtPA) administration.
  
  
  
  Among 259 consecutive acute ischemic stroke patients treated with IVtPA through the Rush tele-stroke program, we compared two cohorts: Period 1 (July 2011 to June 2013) and Period 2 (July 2013 to July 2014). We collected data on demographics, National Institutes of Health Stroke Scale (NIHSS), and times of last known normal (LKN), initiation of tele-stroke consult, and IVtPA administration.
  
  
  
  The mean age was 69.6 years, 56% were female, the mean NIHSS was 11.8, and 41.7% patients were transferred to the hub site. The mean time from initiation of tele-stroke consult to IVtPA administration was 42.2 min. Time from initiation of tele-stroke consult to IVtPA administration improved from Period 1 to Period 2 (49.9 min vs. 35 min, p < 0.0001). This improvement was due to faster mean time from initiation of tele-stroke consult to IVtPA advised (17.4 min vs. 12.5 min, p < 0.0001) and faster mean time from IVtPA advised to administration (33.1 min vs. 22.5 min, p < 0.0001). The mean time from LKN to IVtPA given was also significantly improved (148.6 min vs. 160.9 min, p 0.045).
  
  
  
  Participation in a tele-stroke program associated with improvement in the timeliness of IVtPA delivery.
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center , Chicago, Illinois.
authors.forename: Vivien H
authors.initials: VH
authors.lastname: Lee
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center , Chicago, Illinois.
authors.forename: Shawna
authors.initials: S
authors.lastname: Cutting
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center , Chicago, Illinois.
authors.forename: Sarah Y
authors.initials: SY
authors.lastname: Song
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center , Chicago, Illinois.
authors.forename: Laurel
authors.initials: L
authors.lastname: Cherian
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center , Chicago, Illinois.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Diebolt
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center , Chicago, Illinois.
authors.forename: Joshua
authors.initials: J
authors.lastname: Bock
authors.affiliation: Section of Cerebrovascular Disease, Department of Neurological Sciences, Rush University Medical Center , Chicago, Illinois.
authors.forename: James J
authors.initials: JJ
authors.lastname: Conners
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation / Q000458:organization & administration* / Q000592:standards*; D012959:Socioeconomic Factors; D020521:Stroke / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: intravenous thrombolysis; tele-stroke; telemedicine