A visual task management application for acute ischemic stroke care

Shoji Matsumoto, Hiroshi Koyama, Ichiro Nakahara, Akira Ishii, Taketo Hatano, Tsuyoshi Ohta, Koji Tanaka, Mitsushige Ando, Hideo Chihara, Wataru Takita, Keisuke Tokunaga, Takuro Hashikawa, Yusuke Funakoshi, Takahiko Kamata, Eiji Higashi, Sadayoshi Watanabe, Daisuke Kondo, Atsushi Tsujimoto, Konosuke Furuta, Takuma IshiharaTetsuya Hashimoto, Junpei Koge, Kazutaka Sonoda, Takako Torii, Hideaki Nakagaki, Ryo Yamasaki, Izumi Nagata, Jun Ichi Kira

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: To maximize the effect of intravenous (IV) thrombolysis and/or endovascular therapy (EVT) for acute ischemic stroke (AIS), stroke centers need to establish a parallel workflow on the basis of a code stroke (CS) protocol. At Kokura Memorial Hospital (KMH), we implemented a CS system in January 2014; however, the process of information sharing within the team has occasionally been burdensome. Objective: To solve this problem using information communication technology (ICT), we developed a novel application for smart devices, named “Task Calc. Stroke” (TCS), and aimed to investigate the impact of TCS on AIS care. Methods: TCS can visualize the real-time progress of crucial tasks for AIS on a dashboard by changing color indicators. From August 2015 to March 2017, we installed TCS at KMH and recommended its use during normal business hours (NBH). We compared the door-to-computed tomography time, the door-to-complete blood count (door-to-CBC) time, the door-to-needle for IV thrombolysis time, and the door-to-puncture for EVT time among three treatment groups, one using TCS (“TCS-based CS”), one not using TCS (“phone-based CS”), and one not based on CS (“non-CS”). A questionnaire survey regarding communication problems was conducted among the CS teams at 3 months after the implementation of TCS. Results: During the study period, 74 patients with AIS were transported to KMH within 4.5 h from onset during NBH, and 53 were treated using a CS approach (phone-based CS: 26, TSC-based CS: 27). The door-to-CBC time was significantly reduced in the TCS-based CS group compared to the phone-based CS group, from 31 to 19 min (p = 0.043). Other processing times were also reduced, albeit not significantly. The rate of IV thrombosis was higher in the TCS-based CS group (78% vs. 46%, p = 0.037). The questionnaire was correctly filled in by 34/38 (89%) respondents, and 82% of the respondents felt a reduction in communication burden by using the TCS application. Conclusions: TCS is a novel approach that uses ICT to support information sharing in a parallel CS workflow in AIS care. It shortens the processing times of critical tasks and lessens the communication burden among team members.

Original languageEnglish
Article number1118
JournalFrontiers in Neurology
Volume10
Issue numberOCT
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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