Hyper-Acute Stroke Systems of Care and Workflow.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Current Neurology and Neuroscience Reports Pub Date : 2024-10-01 Epub Date: 2024-08-16 DOI:10.1007/s11910-024-01367-6

Timothy J Kleinig, Patrick McMullan, Geoffrey C Cloud, Prof Christopher Bladin, Anna Ranta

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引用次数: 0

Abstract

Purpose of review: Recent stroke treatment advances have necessitated agile, broad-scale healthcare system redesign, to achieve optimal patient outcomes and access equity. Optimised hyperacute stroke care requires integrated pre-hospital, emergency department, stroke specialist, radiology, neurosurgical and endovascular neurointervention services, guided by a population-wide needs analysis. In this review, we survey system integration efforts, providing case studies, and identify common elements of successful initiatives.

Recent findings: Different regions and nations have evolved varied acute stroke systems depending on geography, population density and workforce. However, common facilitators to these solutions have included stroke unit care as a foundation, government-clinician synergy, pre-hospital pathway coordination, service centralisation, and stroke data guiding system improvement. Further technological advantages will minimize the geographical distance disadvantages and facilitate virtual expertise redistribution to remote areas. Continued treatment advances necessitate an integrated, adaptable, population-wide trans-disciplinary approach. A well-designed clinician-led and government-supported system can facilitate hyperacute care and scaffold future system enhancements.

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超急性期中风护理系统和工作流程。

回顾的目的：近期中风治疗的进展要求对医疗系统进行灵活、广泛的重新设计，以实现最佳的患者预后和公平就医。优化超急性期卒中治疗需要在全人群需求分析的指导下，整合院前、急诊科、卒中专科、放射科、神经外科和血管内神经介入服务。在这篇综述中，我们对系统整合工作进行了调查，提供了案例研究，并确定了成功举措的共同要素：不同地区和国家的急性卒中系统因地理位置、人口密度和劳动力而各不相同。然而，这些解决方案的共同促进因素包括：以卒中单元护理为基础、政府与医生协同合作、院前路径协调、服务集中化以及卒中数据指导系统改进。进一步的技术优势将最大限度地减少地理距离的劣势，促进虚拟专业技术向偏远地区的再分配。治疗技术的不断进步需要一种综合的、适应性强的、覆盖全民的跨学科方法。一个由临床医生主导、政府支持的精心设计的系统可以促进超急性期护理，并为未来的系统改进提供支架。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.