Techniques for improving efficiency in the emergency department for patients with acute ischemic stroke

Ann N Y Acad Sci. 2012 Sep;1268:57-62. doi: 10.1111/j.1749-6632.2012.06663.x.


The past 15 years have witnessed significant strides in the management of acute stroke. The most significant advance, reperfusion therapy, has changed relatively little, but the integrated healthcare systems-stroke systems-established to effectively and safely administer stroke treatments have evolved greatly. Driving change is the understanding that "time is brain." Data are compelling that the likelihood of improvement is directly tied to time of reperfusion. Regional stroke systems of care ensure patients arrive at the most appropriate stroke-capable hospital in which intrahospital systems have been created to process the potential stroke patient as quickly as possible. The hospital-based systems are comprised of prehospital care providers, emergency department physicians and nurses, stroke team members, and critical ancillary services such as neuroimaging and laboratory. Given their complexity, these systems of care require maintenance. Through teamwork and ownership of the process, more patients will be saved from potential death and long-term disability.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Brain Ischemia / diagnosis
  • Brain Ischemia / drug therapy
  • Brain Ischemia / therapy*
  • Delivery of Health Care, Integrated
  • Efficiency
  • Emergency Medical Service Communication Systems
  • Emergency Medical Services
  • Emergency Service, Hospital / organization & administration*
  • Emergency Service, Hospital / statistics & numerical data
  • Facility Design and Construction
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / supply & distribution
  • Fibrinolytic Agents / therapeutic use
  • Hospital Units
  • Humans
  • Medication Systems, Hospital
  • Neuroimaging
  • Patient Admission
  • Patient Care Team
  • Patient Transfer
  • Quality Improvement*
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / supply & distribution
  • Recombinant Proteins / therapeutic use
  • Task Performance and Analysis
  • Telemedicine
  • Thrombolytic Therapy
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / supply & distribution
  • Tissue Plasminogen Activator / therapeutic use
  • Transportation of Patients / organization & administration


  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator