Abstract 175: Applying Toyota Lean Manufacturing Principles to Stroke Care: Accelerating Door-to-Needle times
Clinical Trials Thursday, October 25th, 2012Stroke AHA Journals: November 1, 2012
Recent analysis of National Get-with-the-Guidelines data has shown that less than one third of all patients treated with intravenous tissue plasminogen activator (tPA) had door-to-needle times (DTN) within the ‘Golden Hour’ recommended by current guidelines. Accumulating evidence indicates that shorter DTN is associated with improved outcomes. In March 2011, we began a fundamental transformation, employing Toyota Lean manufacturing principles to improve Emergency Department (ED) DTN in acute ischemic stroke (AIS) patients receiving IV tPA.
Methods: A multi-disciplinary team of ED physicians, Neurologists, Radiologists, Nurses, Patient Care Technologists, Radiology Technologists and Lean Performance Management Engineers critically analyzed the chain of events required to evaluate and treat AIS patients with intravenous tPA. A “current state” value stream Map (VSM) was created to identify barriers and inefficiencies in the process. To address the identified inefficiencies, a “future state” VSM was created and implemented. Time metrics were prospectively collected prior to and after implementation of the “future state” VSM. Read more
