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P.065 The impact of a risk algorithm on time-to-care: targeting triage for acute cerebrovascular syndrome (ACVS) patients in a rapid TIA clinic

Published online by Cambridge University Press:  17 June 2016

M Bibok
Affiliation:
(Victoria)
AR Henri-Bhargava
Affiliation:
(Victoria)
J Morrison
Affiliation:
(Victoria)
K Votova
Affiliation:
(Victoria)
AM Penn
Affiliation:
(Victoria)
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Abstract

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Background: Approximately, one-third of TIA clinics use the ABCD2 score to triage referrals. However, the usefulness of the score is limited because of its low specificity for non-cerebrovascular/mimic conditions. Timely access of referred patients to specialized TIA clinics may reduce recurrent stroke. Methods: The SpecTRA project implemented a novel electronic triage system in the TIA clinic that services Vancouver Island (BC), which replaced the existing ABCD2 triage model. A clinical classifier generating an ACVS probability score was calculated on the basis of the clinic referral form information. Next, a time-varying ABCD2-based risk score derived from Johnston et al. (2007) was calculated, which is then weighted by the ACVS probability score to produce a finalized triage score. Time-to-care was compared pre- (2013/14) and post- (2014/15) implementation. Results: One year results show a statistically significant improvement in that time-to-care for ACVS patients (ABCD2 4/5) was one day earlier with the new triage system (median= 4days since symptom onset; N=250) compared to the previous year (median=5days; N=255) (Mann-Whitney U=38130, p< 0.001). No difference in unit arrival times (median= 5days) for non-cerebrovascular patients was observed (Mann-Whitney U=5563, p= 0.15). Conclusions: The performance of our ACVS triage system highlights quality improvement potential in time-to-care for outpatient TIA clinics.

Type
Poster Presentations
Copyright
Copyright © The Canadian Journal of Neurological Sciences Inc. 2016