Time is brain when it comes to stroke? So is team

  • Dr. Demetrius LopesSubmitted

    Dr. Demetrius LopesSubmitted

 
 
Updated 5/20/2021 9:47 AM

By the end of Stroke Month this May, you'll likely hear this axiom that helps guide how we think about treating this life-threatening condition: "Time is Brain."

We've been saying this for years now because it's simple, easy to remember and describes why it's so serious when a blood clot restricts oxygen to your brain: An untreated stroke can kill 1.9 million brain cells per minute.

 

Stroke is the leading cause of major disability in America. That's why we put so much emphasis on the speed of treatment and teaching people its basic symptoms, such as a terrible headache and weakness on one side of your body or face.

Because we're on the front lines of helping people who suffer strokes, we also know there's another key component to saving lives and preventing lifelong disabilities. To treat people in time, you need an excellent team.

When every second matters, every efficiency and innovative technology your team implements can make a world of difference in the lives of patients and their families. They must coordinate an intricate system of people and practices to help determine a patient's outcome long before a surgeon gets involved. Every 30 minutes delay before treatment reduces the chance of a good outcome by 14%, and every hour of delay ages the brain by 3.6 years compared to a normally aging brain.

At Advocate Aurora Health, we work with regional and community emergency workers in both Illinois and Wisconsin to make a plan to get stroke patients into our hospitals as quickly as possible. Identifying strokes quickly in the field is critical, so we've met with local firefighters and paramedics to help educate and train them to know the symptoms.

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Once a patient arrives, our advanced artificial intelligence developed in just the past few years and deployed at all of our stroke hospitals can help us diagnose a life-threatening stroke faster than ever. That technology means that many times our team is alerted to a possible stroke before the patient even leaves the CT scanner. Meanwhile, our team members perform a coordinated dance, each member concurrently performing specific tasks at precise times, improving our efficiency in providing early intervention.

It helps, too, that our system's scale and community footprint with hospitals scattered throughout the regions we serve, including several key certified stroke centers, allow us to have a larger impact on the stroke patient population. Shorter distances between our stroke centers means less travel and earlier treatment, which has been to shown to improve outcomes with prevention of long term disabilities.

Not only is efficient, expert medical care critical for stroke survival in the early hours of stroke onset, but the hardships of stroke and recovery and rehabilitation also may be eased for patients when it happens closer to home with the support of family and friends. In October, we opened a Comprehensive Stroke Clinic based at Advocate Lutheran General Hospital, which helps stroke patients leave the hospital with a recovery plan and scheduled appointments up to an entire year. They know who they are meeting with and when before they head home. This coordinated clinic brings the experts to the patient in one visit allowing for stroke neurology, neurosurgery, neuroendovascular, physiatry, physical therapy and nursing to collaborate on the goals of recovery and to share this with the patient and family in a one-stop shop follow-up.

All this coordinating and planning is difficult. It doesn't happen overnight. It takes time, energy, effort and investment - all of it even more challenging during the pandemic. But it pays off for the patient in the long run.

                                                                                                                                                                                                                       
 

Staff coordination and improvement in our processes have drastically reduced how long it takes for us to begin a lifesaving procedure called a mechanical thrombectomy after patients arrive at the hospital. Take where we're based, at Advocate Lutheran in Park Ridge, for example. Before all this coordinating in January 2019, it would take about 98 minutes on average from the time a patient arrived to the beginning of the procedure. In January 2020, we got it down to 50 minutes. This January, it was just 28 minutes.

Having good team buys our patients a lot of time.

We're proud of those numbers, of course, as well as the progress we've made in other areas of stroke care. Our network makes life easier for patients in the recovery phase because our significant network gives them and their families a lot of options and the best chance for a meaningful recovery.

But we know better than anyone what those improved numbers mean: More chances for our stroke patients to live well and have more time with their families, often with less severe disabilities.

So we'll keep saying it: Time is Brain.

But also: Team is Brain.

Dr. Demetrius Lopes is co-director of the stroke program for Advocate Aurora Health. Kiffon Keigher is program manager, cerebrovascular stroke system for Advocate Aurora Health.

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