Details
Team
Images
Contacts
Pulsara Memorial
04:17 PM
Last Known Well
Pulsara Case Study: Good Shepherd
Patient
Assign
Assigned Physicians
Bill Richardson - 85M
Name
ED Physician
JackHealth
Dayton
Pulsara
EMS
EMS
ETA
Neurologist
05:40
PM August
Marc
Details
Radiologist
Team
Interventionalist
Images
REDUCTION OF DOOR-TO-NEEDLE TIME
Contacts
Sarah
Burke
Anesthesiologist
Last Known Well
04:17 PM
Assigned
Physicians
Emergency
Department
How one hospital cut its door-toneedle time for stroke patients.
Good Shepherd Medical Center recently adopted a new
approach to stroke care—one that reduced their overall response
time significantly without any other changes to their operating
procedures.
ED Time
Physician
Door
Assign
Jack Dayton
05:30 PM
Neurologist
NIHSS
15
Pulsara alerts critical care team members down
the line,
ensuring
05:36 PM
Radiologist
that everyone remains updated in real time. Critical
care
members
NIHSS Timer
Interventionalist
are ready to go when the patient is, EMS knows
where
Anesthesiologist
06:00 to take
the patient before they arrive at the hospital, and pre-registraEmergency Department
tion information is given before arrival—shortening
the patient’s
Door Time
05:30 PM
journey to a definitive treatment.
Radiology
NIHSS
15
05:36 PM
Marc August
Sarah Burke
Avg
0
60
90
CT Completed
Yes
Timer
The adoption of Pulsara didn’t require Good NIHSS
Shepherd
to
06:00
change any other protocols or processes. They merely added
Completed
a uniform method of communication—a CTArelatively
painless
process. As the Stroke Program Coordinator, Jennifer Reed
Radiology
organized a monthly Stroke Committee meeting
with repreCT Completed
sentatives from the various stakeholders inThrombolytics
the process: both
Contraindications?
hospital-side and EMS-side. They discussed implementingViewthe
Pulsara solution, and decided to move forward
with
a test.05:55 PM
CTA
Completed
Lytics
Given
Avg
BACKGROUND
0
60
90
Avg
Yes
0
60
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0
90
60
90
Yes
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No
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60
90
Yes
Avg
Intervention
RESULTS
In a rural area northeast of Texas, Good Shepherd Medical
Center is a primary stroke center - one of only two in the relatively
large area that they cover. As such, the 426-bed hospital receives
a lot of transfers—EMS flying in or driving in patients from other
facilities up to 60 miles away.
PROBLEM
Being the primary stroke center for such a large area is no easy
task—even with excellent facilities and a well-trained staff. Good
Shepherd faced the same challenges as any hospital: there
wasn't a good way to keep everyone on the same clock and on the
same schedule with their stroke patients. The lack of a consistent
synchronized clock—with some using a watch, others a computer
clock, and still others using a cell phone—meant a whole lot of
uncertainty. Staff faced the challenge of not knowing if everyone
else had the same information, if they were on the same schedule, or if they were ready for the next stage of the process. It also
presented challenges in sharing information between teams.
From an infrastructure standpoint, all the pieces were there. The
hospital had great personnel and first-rate facilities, but a doorto-needle time that routinely clocked in over 60 minutes. In 2012,
the average door-to-needle time hovered between 70 and 110
minutes.
When you’re dealing with stroke patients, every second counts.
Cutting this crucial metric down ultimately means a better
outcome and quality of life for patients.
SOLUTION
Good Shepherd Medical Center looked to improve their door-toneedle time by leveraging Pulsara, a new mobile technology that
links the entire emergency response team together using a single
app to share patient information, benchmark times, and records
across multiple devices. Once activated from any mobile device,
0
60
LVO Suspect?
After introducing Pulsara, door-toneedle times dropped dramatically. In
2014, 93% of Good Shepherd’s stroke
cases had a door-to-needle time of less
than 60 minutes, with 52% of those cases
coming in under 45 minutes.
Change
Change
The case
was
stopped successfully.
Sarah
Burke
No
Bill
Richardson
- 85M
View
Activate
Lytics
GivenIR Team
Yes
05:55
IR Ready?
Intervention
Yes
Activation
to IR Ready
LVO
Suspect?
Avg
0
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Anesthesiologist?
Yes
Times
Interventionalist:
90
Change
Puncture
06:15 PM
Activate IR Team
Yes
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IR Ready?
0
Yes
60
Activation
toPass
IR Ready
Device
First
Avg
90
06:22 PM
Reperfusion
TICI 2B
0
60
90
06:30 PM
Times
Puncture
Last Known Well
02:12
45
PM
Change
60
Sarah Burke
From January to June of 2015, 92% of
stroke cases went from door to needle in
under 60 minutes and 75% of cases were
below 45 minutes. As the hospital adapts
to using Pulsara, their numbers are
continuing to improve. In fact, the hospital
set a new record door-to-needle time of
22 minutes in May.
90
Yes
Assign
Thrombolytics
Anesthesiologist?
Contraindications?
Interventionalist:
30
Door
0
06:15 PMAvg
60:00
Avg
Door
2
90
60
60
Device First Pass
Reperfusion
90
06:22 PM
TICI 2B
In recognition of their dramatic improvement, Good Shepherd
06:30 PM
STOPElite
Medical Center received their first ever Target Stroke
Plus
STROKE nationaward, an award given annually to around 200 hospitals
ally. “When you look at the data, you can’t deny the results,” says
Reed.
Avg
45
30
Door
60
90
Beyond improved metrics,
STOP relations between EMS and the hospital
STROKE
have improved as well. Being able to
automatically report back to EMS the
results of their work—which typically
ends at the door—has been a positive.
Reed was excited to find that it helped
strengthen the ties between EMS and
the hospital. And it makes sense; EMS
is in the business of saving lives, and
it’s important to see the results of one’s
efforts. The use of Pulsara has bred a
sense of teamwork that is a valuable
asset in critical care.
Ultimately, the greatest result has
been an improved outlook and quality
of life for the patients served by Good
Shepherd.
For additional studies, video demonstrations, and furthur information, visit our website at www.pulsara.com.
© Pulsara 2014-2016