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New In RES-Q | Key Priority Actions Impact DTN Time

Seeing is believing. The updated RES-Q dashboard provides a compelling argument for implementing Angels-recommended key priority actions in the hyperacute phase.
Angels team 24 February 2023


Updated RES-Q dashboards now show DTN time as a function of four key priority actions recommended by Angels, namely EMS prenotification, taking the patient directly to CT, POC testing for INR, and commencing treatment at CT. The impact of these actions on treatment times are now visible at a glance.

The new enhanced hospital dashboards provide feedback on all the variables collected in RES-Q. Reducing DTN time is one of the most important metrics for monitoring quality improvement in stroke care, and RES-Q now displays DTN feedback based on different scenarios.

The new data fields were added at the suggestion of Angels project lead Jan van der Merwe. Dr Robert Mikulik, founder and co-ordinator of Res-Q, confirmed at the beginning of February 2023 that the standard RES-Q dashboard now has visualisation of DNT as a function of all four priority actions.

Hospitals can now see at a glance:

• the DTN time when the hospital was prenotified vs without prenotification.

• the DTN time as a function of place of admission, i.e. direct to CT/MRI, emergency department or outpatient clinic.

• the DTN time when POC was used for INR vs when bloods were sent to the lab.

• the DTN time as a function of the location where IVT commences, i.e. CT/MRI room, stroke unit/ICU or emergency room.

In the example above, a hospital achieved a DTN time of 20 minutes for patients that went directly to CT as compared to 69 minutes for patients admitted to the emergency department. When the hospital was prenotified of a stroke patient's arrival, treatment commenced after 20 minutes as opposed to 55 minutes without EMS prenotification.

The median DTN time for patients treated with IVT in the CT room was 15 minutes. If the patient was transferred to the stroke unit or ICU ahead of treatment, the DTN time jumped to 31 minutes. 

The new dashboard will encourage hospitals to make these key priority actions part of their stroke protocol, Jan van der Merwe says. 

“Seeing is believing. We are confident this data will inspire hospitals to implement actions known to reduce DTN times.”


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