WASHINGTON — Precious moments count when someone has a stroke, and two hospitals in the D.C. area say they have come up with a way to get a better diagnosis in time to administer effective treatment.
Stroke teams at MedStar Washington Hospital Center and Suburban Hospital have been using MRIs to image the brains of stroke patients instead of the commonly used CT scans.
The rap against MRIs has long been that, while they produce superior results, they take too long at a time when even seconds matter.
The two local stroke teams — part of the National Institutes of Health’s clinical research stroke program — set out to find a way to use MRIs and still get patients diagnosed within one hour from the time they enter the emergency room.
“What we were aiming to do was be able to treat our stroke patients with tPA (tissue plasminogen activator) — the only FDA-approved medication to treat stroke — and scan our patients with MRI, all under 60 minutes,” says Dr. Amie Hsia, medical director of the comprehensive stroke center at MedStar Washington Hospital Center.
To do this, they took a lesson from factory work flows, looking at every detail of the process along the way.
Doctors, nurses, technicians and pharmacists all got involved in the search for greater efficiency, ultimately shaving enough time to enable the use of an MRI to provide a detailed picture of the stroke as it is happening.
Hsia says they cut precious minutes by removing staffing redundancies, cutting down on paperwork — including the long, involved screening forms used for MRIs outside an emergency setting — and even putting doses of tPA in the MRI suite to cut the time that would have been used to transport a patient back to their room for treatment.
The teams reported their findings — and even provided copies of their shorter screening forms for others to use — in the journal Neurology.
Hsia, for one, is enthusiastic about the prospects for the future: “We have shown now that this can be done, and we think this really opens the door for acute stroke evaluation at hospitals around the country and the world.”
