Process Improvement in Stroke Patient Care

With a focus on process improvement, Metro Health University of Michigan Health saw an opportunity to change the way they communicated around the care delivery of stroke patients. Although Metro Health was already a recognized Comprehensive Stroke Center facility, the Neuroscience team strived to do better.

Metro Health faced the challenge of capturing appropriate data elements and mapping detailed workflows to identify areas for process improvement and potential re-engineering. Their overall vision and goal was to use the EHR to capture structured data, validate the data and produce reports in all areas of care delivery.

Building an Improved Communication Vehicle

The implementation approach included a combination of technology, process improvement and clinical decision support (CDS) tools. Quality and process improvement experts analyzed workflows and engineered improvements that included EHR alerts and supported business intelligence.

By continually mapping the emergency department (ED) patient flows, staff was able to:

• monitor patient flows through all variables of care for a stroke patient while in the ED
• pinpoint opportunities for improvement and efficiency; the patient flows were monitored through all variables of care for a stoke patient while in the ED
• activate a CDS alert at the point of care for stroke patients

Using the improved communication platform, now staff can alert physicians and advance practice providers faster and more efficiently while incorporating important decision-making information within patient communications, such as patient age, medical record number, room number and the patient’s last confirmed status of wellbeing. Having immediate access to this information provides Metro Health’s stroke care team the opportunity to prepare for a stroke patient’s care before they arrive in the ED.

As a result of these overall process improvements, Metro Health lowered door-to-needle time from 53 to 29 minutes – saving roughly 48 million brain cells, leading to a much greater chance of surviving a stroke without major disabilities.

Electronic Medical Record Adoption Model Stage 7 Validation

HIMSS is pleased to recognize Metro Health for their HIMSS Electronic Medical Record Adoption Model (EMRAM) Stage 7 validation. The organization also earned a HIMSS Outpatient Electronic Medical Record Adoption Model Stage 7 validation.

“Metro Health initiated a program to identify delays in stroke patients’ care delivery,” said Philip Bradley, regional director, North America, HIMSS Analytics. “Using the data to identify the timing of the steps in care, the Metro Health team implemented changes that reduced the door-to-needle time from 53 minutes to 29 minutes.”

“Metro Health – University of Michigan Health is pleased to receive the HIMSS Analytics EMRAM Stage 7 validation, but most proud of the teamwork involved, by engaging numerous clinical leaders and an incredible IT staff,” said Brad Clegg, DO, MMM, chief medical information officer at Metro Health. ”There has never been a challenge our team has not been able to meet or exceed while continuing to make the technology better so that we can improve our processes of care, our outcomes, and the satisfaction of our patients and providers.”

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Updated February 21, 2020