AUTHOR=Matsumoto Shoji , Koyama Hiroshi , Nakahara Ichiro , Ishii Akira , Hatano Taketo , Ohta Tsuyoshi , Tanaka Koji , Ando Mitsushige , Chihara Hideo , Takita Wataru , Tokunaga Keisuke , Hashikawa Takuro , Funakoshi Yusuke , Kamata Takahiko , Higashi Eiji , Watanabe Sadayoshi , Kondo Daisuke , Tsujimoto Atsushi , Furuta Konosuke , Ishihara Takuma , Hashimoto Tetsuya , Koge Junpei , Sonoda Kazutaka , Torii Takako , Nakagaki Hideaki , Yamasaki Ryo , Nagata Izumi , Kira Jun-ichi 

TITLE=A Visual Task Management Application for Acute Ischemic Stroke Care

JOURNAL=Frontiers in Neurology

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.01118

DOI=10.3389/fneur.2019.01118

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> To maximize the effect of intravenous (IV) thrombolysis and/or endovascular therapy (EVT) for acute ischemic stroke (AIS), stroke centers need to establish a parallel workflow on the basis of a code stroke (CS) protocol. At Kokura Memorial Hospital (KMH), we implemented a CS system in January 2014; however, the process of information sharing within the team has occasionally been burdensome.</p><p><bold>Objective:</bold> To solve this problem using information communication technology (ICT), we developed a novel application for smart devices, named “Task Calc. Stroke” (TCS), and aimed to investigate the impact of TCS on AIS care.</p><p><bold>Methods:</bold> TCS can visualize the real-time progress of crucial tasks for AIS on a dashboard by changing color indicators. From August 2015 to March 2017, we installed TCS at KMH and recommended its use during normal business hours (NBH). We compared the door-to-computed tomography time, the door-to-complete blood count (door-to-CBC) time, the door-to-needle for IV thrombolysis time, and the door-to-puncture for EVT time among three treatment groups, one using TCS (“TCS-based CS”), one not using TCS (“phone-based CS”), and one not based on CS (“non-CS”). A questionnaire survey regarding communication problems was conducted among the CS teams at 3 months after the implementation of TCS.</p><p><bold>Results:</bold> During the study period, 74 patients with AIS were transported to KMH within 4.5 h from onset during NBH, and 53 were treated using a CS approach (phone-based CS: 26, TSC-based CS: 27). The door-to-CBC time was significantly reduced in the TCS-based CS group compared to the phone-based CS group, from 31 to 19 min (<italic>p</italic> = 0.043). Other processing times were also reduced, albeit not significantly. The rate of IV thrombosis was higher in the TCS-based CS group (78% vs. 46%, <italic>p</italic> = 0.037). The questionnaire was correctly filled in by 34/38 (89%) respondents, and 82% of the respondents felt a reduction in communication burden by using the TCS application.</p><p><bold>Conclusions:</bold> TCS is a novel approach that uses ICT to support information sharing in a parallel CS workflow in AIS care. It shortens the processing times of critical tasks and lessens the communication burden among team members.</p>