TeleStroke Case Study: Memorial Hospital of Jacksonville

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TeleStroke Case Study: Memorial Hospital of Jacksonville

About HCA Memorial Hospital of Jacksonville

This hospital is a 454-bed acute care hospital located in Jacksonville, Florida. This hospital has been a leader in providing quality healthcare to Northeast Florida and is a Certified Primary Stroke Center through The Joint Commission.

The Problem

There were inconsistencies and variations in the stroke alert process, leading to alteplase administration delays and Door-to-Needle (DTN) times above the 45-minutes facility goal.

The Solution

A comprehensive review of the current stroke process was completed, and areas of common delays were streamlined using American Stroke Association best practice recommendations and TeleSpecialists’ guidelines.

The changes included:

  • Implementation of a Pit Stop to quickly assess and obtain key treatment elements (blood glucose, weight, blood pressure) within a 5-minutes or less goal, then immediately obtain imaging
  • A stroke kit containing alteplase and blood pressure medications was relocated to CT to ensure quick access and availability (implemented Q3 2020)
  • Consistently taking the TeleStroke cart to CT to ensure the neurologist can quickly assess and make decisions on treatment
  • Alteplase administration is consistently completed in Radiology with the neurologist remaining on screen to assist staff with dosing
  • A time out procedure is conducted to review patient safety measures prior to administration

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