Tuesday, June 02, 2015

From biblical times to modern hospitals, timing can make all the difference

From Flickr by Sean MacEntee

Starting out in left field here. One of my favorite books in the Bible is Acts. Why? Because a lot of important events are happening quickly, and timing is critical. The order of events is part of a grand plan there.

I like timing things in life, too. I'm not as good as God with timing, but when my sequence of actions works, it gives me a great deal of satisfaction.

So, I'm interested in this recent story about how workflow processes can be a success, showing how clot busters can be delivered in an hour, even with an MRI:
Two centers -- one academic, one community -- that use MRI as part of an NIH study dropped their median DTN [Jeff's note: DTN stands for door-to-needle, or the time between the patient enters the hospital to the time of stroke treatment] time from 93 to 55 minutes after focusing their workflow processes, Amie Hsia, MD, of MedStar Washington Hospital Stroke Center, and colleagues reported online in Neurology.
"Our fastest times were 36 to 37 minutes, we didn't even think that was achievable with MRI," Hsia told MedPage Today. "It shows the power of a focused effort to make a process more efficient." 
The academic center MedStar Washington Hospital Center and the community Suburban Hospital participated in a National Institute for Neurological Disorders and Stroke study to evaluate the utility of MRI in stroke diagnosis and treatment.
Hsia said that given a large international push to decrease DTN times to within 60 minutes of arrival at a hospital, her team "had to respond to this" even though the use of MRI takes longer than CT to perform.
Yet MRI has been said to hold advantages over CT in stroke diagnosis and treatment, since it can give better information about the size and location of the ischemia, its duration, the presence of hemorrhage and vessel occlusion, and greater insight into underlying etiology.
"The power of a focused effort" is indeed a power to consider. I'm amazed how often hospitals are disorganized (see recent posts about people having a stroke while being hospital patients). This report provides some interesting information showing how much better care can be with that "focused effort."

Think of it. Better treatment. Better outcome. Less loss of life. Fewer people leaving hospitals with a disability. More people coming home. More productive lives. Timing can make or break all these things.

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