Using “lean” manufacturing principles to speed up treatment times for stroke victims may improve the effectiveness of a clot-busting protein used to treat to treat and reduce brain injury after embolic or thrombotic strokes, according to new research in the American Heart Association’s journal Stroke.
In an observational study, the average time between patients arriving at Barnes-Jewish Hospital in St. Louis, MO, and receiving tissue plasminogen activator (tPA), decreased 21 minutes using process improvement techniques adapted from the auto industry. Data from more than 200 patients ranging over three years was included in the analysis. The shorter the time between patients arriving at the hospital and receiving tPA, the greater the chance to reduce brain injury after stroke, researchers said.
Streamlining steps included identifying unnecessary or inefficient items, such as inefficient patient transportation, tasks performed singly instead of simultaneously, and time-consuming traditional lab-based tests. Protocols were formulated to eliminate waste, keeping only crucial steps that added “value” to patient care, in keeping with lean methods to eliminate inefficiencies.
As a result of the initiatives implemented, 78 percent of stroke patients received tPA within one hour of arrival. The national database indicates that only about 30 percent of patients in the United States are treated within one hour. Overall treatment time at Barnes-Jewish was reduced from 60 minutes to 39 minutes and sustained for a year after implementation.