Pre-Hospital Pathway Aid: Reducing decision making to 10 seconds for suspected stroke patients in Greater Manchester

Manchester icon Greater Manchester

Challenge

When a patient has a stroke, time is critical. In Greater Manchester (GM), patients with suspected stroke are taken by ambulance to a Hyper Acute Stroke Unit (HASU). Data collected by the GM Operational Delivery Network suggests that 30-50% of patients brought to HASUs turn out to have a different diagnosis. As well as diverting resource and time away from stroke patients, non-stroke patients with diagnoses such as seizures and sepsis are likely to have received faster care at their local hospital. Currently, pre-hospital clinicians must rule out a number of pathway exclusions, intended to divert unstable patients to the nearest hospital. This process is done manually and can take up to 10 minutes.

Solutions

Colleagues from Salford Royal NHS Foundation Trust have developed a smartphone app with industry partner D2Digital to aid pre-hospital clinicians in stroke pathway compliance. The app reproduces the current pathway, identifies the nearest HASU or A&E, and prompts a pre-alert to the hospitals for selected patients.  This reduces a process that took 10 minutes down to 10 seconds. For patients with stroke caused by brain haemorrhage this precious time is invaluable. Time-sensitive treatments such as the reversal of anticoagulation and the lowering of blood pressure, together with neurosurgical treatment have helped to save 2 lives a month at Salford Royal alone. Connected Health Cities (CHC) are now working to roll out this care bundle across the entire Greater Manchester region.

Future

CHC is currently using and testing the app on pathways of care for stroke and measuring the clinical effectiveness using HASU data before and after implementation. The app itself has been developed to support all pre-hospital pathways including cardiac arrest, trauma, and sepsis and will be rolled out across the North West Ambulance Service in 2018.

Click here to find out more about the GM Connected Health City Stroke project.