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9. Simulation-Based Training of the Rapid Evaluation and Management of Acute Stroke (STREAM)-A Prospective Single-Arm Multicenter Trial

Author

Bohmann, Ferdinand O., Kurka, Natalia, de Rochemont, Richard du Mesnil, Gruber, Katharina, Guenther, Joachim, Rostek, Peter, Rai, Heike, Zickler, Philipp, Ertl, Michael, Berlis, Ansgar, Poli, Sven, Mengel, Annerose, Ringleb, Peter, Nagel, Simon, Pfaff, Johannes, Wollenweber, Frank A., Kellert, Lars, Herzberg, Moriz, Koehler, Luzie, Haeusler, Karl Georg, Alegiani, Anna, Schubert, Charlotte, Brekenfeld, Caspar, Doppler, Christopher E. J., Onur, Oezguer A., Kabbasch, Christoph, Manser, Tanja, Pfeilschifter, Waltraud, Alotaibi, Mohammad, Batarfi, AbdulAziz, Brandhofe, Annemarie, Kestner, Roxane-Isabelle, Schaefer, Jan Hendrik, Schaller, Martin Alexander, Seiler, Alexander, Wallenwein, Stephanie, Willems, Laurent M., Steinmetz, Helmuth, Hattingen, Elke, Kos, Zeljko, Naumann, Markus, Blum, Corinna, Bombach, Paula, Zeller, Julia, Gumbinger, Christoph, Regula, Jens, Horstmann, Solveig, Heyse, Miriam, Dorozewski, Eva, Lamentner, Christian, I, Tilman, Reiff, Schieber, Simon, Mundiyanapurath, Sibu, Schoenenberger, Silvia, Mokli, Yahia, Moehlenbruch, Markus, Bewersdorf, Jan, Einhaeupl, Maximilian, Feil, Katharina, Klein, Matthias, Moehwald, Ken, Muehlbauer, Konstanze, Mulazzani, Mathias, Rohrer, Guido, Schoenedcer, Sonja, Dorn, Franziska, Mennemeyer, Philipp, Sandner, Torleif, Huber, Brigitte, Hill, Julia, Gavran, Jela, Audebert, Heinrich, Geran, Rohat, Schurig, Johannes, Lerm, Juliane, I, Kleefeld, Felix, Schoknecht, Karl, Jadranka, Denes, Brade, Kirsten, Wittenberg, Tatjana, Mayer-Runge, Ulrich, Bester, Maxim, Schoenfeld, Michael H., Flottmann, Fabian, Prilop, Lisa, Leischner, Iannes, Froelich, Andreas Maximilian, Roesner, Sabine, Broocks, Gabriel, Hanning, Uta, Guder, Stephanie, Bechstein, Matthias, Lange, Carmen, Kautz, Sebastian, Higgen, Focko L., Kyselyova, Anna, Thomalla, Goetz, Fiehler, Jens, Fink, Gereon Rudolf, Bonkhoff, Anna, Dronse, Julian, Kirsch, Katharina, Laurent, Sarah, von Reutern, Boris, Rosen, Jurij, Volz, Lukas, Werner, Jan-Michael, Woking, Michael, Seliger, Robert, Yildirim, Abdulkadir, Schlamann, Marc, Borggrefe, Jan, Bohmann, Ferdinand O., Kurka, Natalia, de Rochemont, Richard du Mesnil, Gruber, Katharina, Guenther, Joachim, Rostek, Peter, Rai, Heike, Zickler, Philipp, Ertl, Michael, Berlis, Ansgar, Poli, Sven, Mengel, Annerose, Ringleb, Peter, Nagel, Simon, Pfaff, Johannes, Wollenweber, Frank A., Kellert, Lars, Herzberg, Moriz, Koehler, Luzie, Haeusler, Karl Georg, Alegiani, Anna, Schubert, Charlotte, Brekenfeld, Caspar, Doppler, Christopher E. J., Onur, Oezguer A., Kabbasch, Christoph, Manser, Tanja, Pfeilschifter, Waltraud, Alotaibi, Mohammad, Batarfi, AbdulAziz, Brandhofe, Annemarie, Kestner, Roxane-Isabelle, Schaefer, Jan Hendrik, Schaller, Martin Alexander, Seiler, Alexander, Wallenwein, Stephanie, Willems, Laurent M., Steinmetz, Helmuth, Hattingen, Elke, Kos, Zeljko, Naumann, Markus, Blum, Corinna, Bombach, Paula, Zeller, Julia, Gumbinger, Christoph, Regula, Jens, Horstmann, Solveig, Heyse, Miriam, Dorozewski, Eva, Lamentner, Christian, I, Tilman, Reiff, Schieber, Simon, Mundiyanapurath, Sibu, Schoenenberger, Silvia, Mokli, Yahia, Moehlenbruch, Markus, Bewersdorf, Jan, Einhaeupl, Maximilian, Feil, Katharina, Klein, Matthias, Moehwald, Ken, Muehlbauer, Konstanze, Mulazzani, Mathias, Rohrer, Guido, Schoenedcer, Sonja, Dorn, Franziska, Mennemeyer, Philipp, Sandner, Torleif, Huber, Brigitte, Hill, Julia, Gavran, Jela, Audebert, Heinrich, Geran, Rohat, Schurig, Johannes, Lerm, Juliane, I, Kleefeld, Felix, Schoknecht, Karl, Jadranka, Denes, Brade, Kirsten, Wittenberg, Tatjana, Mayer-Runge, Ulrich, Bester, Maxim, Schoenfeld, Michael H., Flottmann, Fabian, Prilop, Lisa, Leischner, Iannes, Froelich, Andreas Maximilian, Roesner, Sabine, Broocks, Gabriel, Hanning, Uta, Guder, Stephanie, Bechstein, Matthias, Lange, Carmen, Kautz, Sebastian, Higgen, Focko L., Kyselyova, Anna, Thomalla, Goetz, Fiehler, Jens, Fink, Gereon Rudolf, Bonkhoff, Anna, Dronse, Julian, Kirsch, Katharina, Laurent, Sarah, von Reutern, Boris, Rosen, Jurij, Volz, Lukas, Werner, Jan-Michael, Woking, Michael, Seliger, Robert, Yildirim, Abdulkadir, Schlamann, Marc, and Borggrefe, Jan

Abstract

Introduction: Acute stroke care delivered by interdisciplinary teams is time-sensitive. Simulation-based team training is a promising tool to improve team performance in medical operations. It has the potential to improve process times, team communication, patient safety, and staff satisfaction. We aim to assess whether a multi-level approach consisting of a stringent workflow revision based on peer-to-peer review and 2-3 one-day in situ simulation trainings can improve acute stroke care processing times in high volume neurocenters within a 6 months period. Methods and Analysis: The trial is being carried out in a pre-test-post-test design at 7 tertiary care university hospital neurocenters in Germany. The intervention is directed at the interdisciplinary multiprofessional stroke teams. Before and after the intervention, process times of all direct-to-center stroke patients receiving IV thrombolysis (IVT) and/or endovascular therapy (EVT) will be recorded. The primary outcome measure will be the door-to-needle time of all consecutive stroke patients directly admitted to the neurocenters who receive IVT. Secondary outcome measures will be intervention-related process times of the fraction of patients undergoing EVT and effects on team communication, perceived patient safety, and staff satisfaction via a staff questionnaire. Interventions: We are applying a multi-level intervention in cooperation with three STREAM multipliers from each center. First step is a central meeting of the multipliers at the sponsor's institution with the purposes of algorithm review in a peer-to-peer process that is recorded in a protocol and an introduction to the principles of simulation training and debriefing as well as crew resource management and team communication. Thereafter, the multipliers cooperate with the stroke team trainers from the sponsor's institution to plan and execute 2-3 one-day simulation courses in situ in the emergency department and CT room of the trial centers wher

Published
2019

10. [Emergency care: need for reform from the inpatient perspective].

Author

Schultze A and Mayer-Runge U

Subjects
Emergency Service, Hospital, Emergency Treatment, Hospitalization, Humans, Emergency Medical Services, Inpatients
Abstract

The interdisciplinary central emergency department is increasingly establishing itself as the new gold standard of inpatient emergency care. Not all emergency patients whose complaints need to be assessed with the resources of an emergency department are ultimately admitted as inpatients. For all other emergencies, correct allocation decisions must be made at an early stage and preferred paths for clarification and treatment that relieve hospital emergency rooms must be offered. Qualification requirements for emergency care staff have so far been highly inconsistent for the three sectors. It is also necessary to jointly establish quality assurance measures for the cooperation between the outpatient and inpatient sectors as well as the emergency medical services., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Published
2022
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