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Practice Makes Perfect

A story from Iceland positions simulation as a skills-building, habit-forming exercise that, if repeated often enough, can produce extraordinary results.
Angels team 10 October 2022


One of our favourite success stories is a practice-makes-perfect anecdote from Iceland with simulation at the centre. The heroes of this story are three nurses from Landspitali University Hospital (LUH) in Reykjavik, where nearly all stroke patients in sparsely populated Iceland are treated and where 70 percent of Icelandic children are born.

We met Marianne Klinke, Kristín Ásgeirsdóttir and Jónína Haflíðadóttir in December 2017 at our first-ever Train-the-trainer event in Wiesbaden. Train-the-trainer events are typically aimed at neurologists, but the nurses from Iceland were determined to extract as much value as possible and then share what they’d learnt with LUH doctors and nurses. Their goal was to cut door-to-treatment times at this hospital by 50% within six months, and double the recanalisation rate.

Less than five months later, in May 2018, LUH reported that the number of patients undergoing recanalisation treatment for stroke had increased by 296 percent (compared to 2014-2016). Their average door-to-treatment time had dropped from 79 to a world-class 25 minutes, with a record time of 13 minutes.

The main reason they had tripled their goals in less than the set time frame was that nurses Klinke, Ásgeirsdóttir and Haflíðadóttir had, upon their return from Wiesbaden, conducted a series of pathway simulations involving the entire stroke team. Not only had insights gleaned from these simulations shaped the stroke pathway, but the more they practiced the faster they became.

The same nursing team impressed us with the speed with which they’d implemented the FeSS protocol in the stroke unit, and shared these life-saving protocols for post-acute care not only in their hospital but with the Icelandic patients’ stroke association as well. They’d also initiated a quality monitoring project, collecting valid baseline data from approximately 200 patients to compare before-and-after metrics. 

Unsurprisingly, their project was named Best Project of the Year at LUH. Four years on, this bright spot from Iceland continues to shine and to inspire other hospitals and nurses in the Angels network. 

* An earlier version of this story appeared on our website in August 2018. Read the original story here


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