Abstract 3536: Expanding Telestroke Partnerships: Building A Quality Assessment And Improvement Program To Support A Stroke System Of Care
Notice bibliographique
Résumé
Throughout the U.S., many hospitals lack infrastructure and resources to provide acute stroke care rescue therapy. In a Washington state review (2008), it was determined that of hospitals which admit stroke patients only 50.7% had a neurologist available and 18.3% had a stroke team. Telestroke, although an efficient and cost effective way to bring neurological expertise to patients, has not been traditionally implemented to address other components of a system of care, such as transfer decisions and inpatient care requirements. A partnership (philanthropically supported) was created with the goal of supporting the expansion of traditional telestroke relationships commensurate with system of stroke care requirements. This consortium was created in Washington state amongst a tertiary stroke center and four centers who receive Telestroke services. This expanded relationship built upon basic telemedicine technology and training infrastructure and added in clinical training for inpatient unit staff, and development and implementation of a collaborative dashboard with quality metrics benchmarked against Joint Commission Primary Stroke Centers. Implementation strategies comprised partnering agreements, deployment of teams responsible for IT, training, and administrative tasks. Quality was addressed during monthly meetings and quarterly workshops. Comprehensive training programs were administered and tailored to meet specific needs assessment of each site with additional training offered via live streaming and archived series designed to address systems of stroke care. Communities, organizations and patients have benefited by the creation of a system which promotes local provision of care and the early development of a system of stroke care. Outcomes have included assured access to specialists when needed, improved patient selection for thrombolysis with some sites witnessing an increase in the number of patients who were appropriately treated with rtPA. In addition to rtPA usage and availability, patients have benefited from access to tertiary services such as advanced imaging, care consultations with vascular neurologists, and interventional services. All organizations have benefited from the collaboration resulting in local implementation of shared best practices. The program has been useful as a model for the establishment of Stroke Systems of Care in Washington. This implementation program may be a model for developing patient centered stroke systems of care recognizing that care needs extend beyond the IV thrombolytic process.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,033 | 0,029 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,004 | 0,001 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,002 | 0,012 |
| Intégrité de la recherche | 0,002 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».