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Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)

BACKGROUND: Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years’ experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. METHODS: Th...

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Autores principales: Gabriel, Katharina M. A., Jírů-Hillmann, Steffi, Kraft, Peter, Selig, Udo, Rücker, Viktoria, Mühler, Johannes, Dötter, Klaus, Keidel, Matthias, Soda, Hassan, Rascher, Alexandra, Schneider, Rolf, Pfau, Mathias, Hoffmann, Roy, Stenzel, Joachim, Benghebrid, Mohamed, Goebel, Tobias, Doerck, Sebastian, Kramer, Daniela, Haeusler, Karl Georg, Volkmann, Jens, Heuschmann, Peter U., Fluri, Felix
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081707/
https://www.ncbi.nlm.nih.gov/pubmed/32192438
http://dx.doi.org/10.1186/s12883-020-01676-6
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author Gabriel, Katharina M. A.
Jírů-Hillmann, Steffi
Kraft, Peter
Selig, Udo
Rücker, Viktoria
Mühler, Johannes
Dötter, Klaus
Keidel, Matthias
Soda, Hassan
Rascher, Alexandra
Schneider, Rolf
Pfau, Mathias
Hoffmann, Roy
Stenzel, Joachim
Benghebrid, Mohamed
Goebel, Tobias
Doerck, Sebastian
Kramer, Daniela
Haeusler, Karl Georg
Volkmann, Jens
Heuschmann, Peter U.
Fluri, Felix
author_facet Gabriel, Katharina M. A.
Jírů-Hillmann, Steffi
Kraft, Peter
Selig, Udo
Rücker, Viktoria
Mühler, Johannes
Dötter, Klaus
Keidel, Matthias
Soda, Hassan
Rascher, Alexandra
Schneider, Rolf
Pfau, Mathias
Hoffmann, Roy
Stenzel, Joachim
Benghebrid, Mohamed
Goebel, Tobias
Doerck, Sebastian
Kramer, Daniela
Haeusler, Karl Georg
Volkmann, Jens
Heuschmann, Peter U.
Fluri, Felix
author_sort Gabriel, Katharina M. A.
collection PubMed
description BACKGROUND: Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years’ experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. METHODS: The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. RESULTS: Overall, 7881 patients were included (mean age 74.6 years ±12.8; 48.4% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31%), mainly in secondary stroke prevention; b) improvement over time (44%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. CONCLUSION: The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals.
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spelling pubmed-70817072020-03-23 Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke) Gabriel, Katharina M. A. Jírů-Hillmann, Steffi Kraft, Peter Selig, Udo Rücker, Viktoria Mühler, Johannes Dötter, Klaus Keidel, Matthias Soda, Hassan Rascher, Alexandra Schneider, Rolf Pfau, Mathias Hoffmann, Roy Stenzel, Joachim Benghebrid, Mohamed Goebel, Tobias Doerck, Sebastian Kramer, Daniela Haeusler, Karl Georg Volkmann, Jens Heuschmann, Peter U. Fluri, Felix BMC Neurol Research Article BACKGROUND: Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years’ experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. METHODS: The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. RESULTS: Overall, 7881 patients were included (mean age 74.6 years ±12.8; 48.4% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31%), mainly in secondary stroke prevention; b) improvement over time (44%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. CONCLUSION: The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals. BioMed Central 2020-03-19 /pmc/articles/PMC7081707/ /pubmed/32192438 http://dx.doi.org/10.1186/s12883-020-01676-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Gabriel, Katharina M. A.
Jírů-Hillmann, Steffi
Kraft, Peter
Selig, Udo
Rücker, Viktoria
Mühler, Johannes
Dötter, Klaus
Keidel, Matthias
Soda, Hassan
Rascher, Alexandra
Schneider, Rolf
Pfau, Mathias
Hoffmann, Roy
Stenzel, Joachim
Benghebrid, Mohamed
Goebel, Tobias
Doerck, Sebastian
Kramer, Daniela
Haeusler, Karl Georg
Volkmann, Jens
Heuschmann, Peter U.
Fluri, Felix
Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)
title Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)
title_full Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)
title_fullStr Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)
title_full_unstemmed Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)
title_short Two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)
title_sort two years’ experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the transregional network for stroke intervention with telemedicine (transit-stroke)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081707/
https://www.ncbi.nlm.nih.gov/pubmed/32192438
http://dx.doi.org/10.1186/s12883-020-01676-6
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