UNC Johnston TeleStroke Case Study
UNC Health is an integrated healthcare system owned by the state of North Carolina and based in Chapel Hill. Known as “North Carolina’s Health Care System,” UNC Health provides care to patients in all of the state’s 100 counties. Two of the UNC Health system facilities – UNC Johnston Smithfield and UNC Johnston Clayton partner with us, TeleSpecialists, to provide the best on call telehealth neuro care for their patients.
Throughout 2022, the activation time (when the patient arrives to when the TeleNeurologist is notified) was lengthy, and the process was inconsistent.
In addition, there was a delay in decision time for thrombolytic as the telehealth cart did not go to CT, so the scans could not be viewed as occurring. In January 2023, both facilities had a major focus on staff education as well as the deployment of best practices.
Based on the current stroke workflow, the following key strategies were deployed, resulting in a 45% – 50% improvement in activation time. Consequently, the door-to-needle (DTN) time was reduced by 22% at UNC Johnston Clayton and 40% at UNC Johnston Smithfield from quarter one to quarter two, 2023. A summary of the strategies were:
- Training was given to all nursing staff with a focus on early recognition of stroke symptoms
- Taking the cart to CT encouraged activation prior to CT rather than after CT
- Successful DTN recognition was implemented across both sites to foster overall improvement in the Stroke Alert Process through friendly competition