Telestroke for Comprehensive Transient Ischemic Attack Care in Acute Stroke Ready Hospitals
| Status: | Recruiting |
|---|---|
| Conditions: | Peripheral Vascular Disease, Neurology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/1/2018 |
| Start Date: | October 2, 2018 |
| End Date: | July 2, 2020 |
| Contact: | Christopher Streib, MD |
| Email: | streib@umn.edu |
| Phone: | 6126251969 |
TELECAST-TIA is a prospective single-center study evaluating guideline-based transient
ischemic attack (TIA) treatment at an Acute Stroke Ready Hospital (ASRH) pre- and
post-initiation of a specialist telestroke inpatient rounding service. TELECAST-TIA will
study the following clinical endpoints: diagnostic stroke evaluation, secondary stroke
prevention, health screening and evaluation, stroke education, inpatient complications, and
stroke recurrence rates. Additional relevant non-clinical data will include patient and
provider satisfaction scores, transfer patterns, and a cost analysis.
ischemic attack (TIA) treatment at an Acute Stroke Ready Hospital (ASRH) pre- and
post-initiation of a specialist telestroke inpatient rounding service. TELECAST-TIA will
study the following clinical endpoints: diagnostic stroke evaluation, secondary stroke
prevention, health screening and evaluation, stroke education, inpatient complications, and
stroke recurrence rates. Additional relevant non-clinical data will include patient and
provider satisfaction scores, transfer patterns, and a cost analysis.
Telestroke is a validated intervention that improves the triage and emergent treatment of
acute stroke, specifically related to the use of intravenous thrombolysis. Effective urgent
stroke evaluation and secondary stroke prevention is also essential to decrease the risk of
recurrent stroke, however, there have been no studies to date examining the use of telestroke
to improve delivery of non-emergent inpatient stroke care per American Heart Association
(AHA) guidelines.
Currently, access to stroke specialist expertise is limited resulting in significant
disparities in stroke care. Previous publications have identified that patients in rural
areas may receive sub-optimal stroke care that does not follow accepted guideline
recommendations. Telestroke is a cost-effective mechanism to deliver specialist stroke care
to hospitals that do not have in-person stroke consultation available. The aim of
TELECAST-TIA is to determine whether specialist telestroke inpatient rounding improves
guideline-based TIA treatment when compared to non-specialist transient ischemic attack
treatment.
The primary outcome of TELECAST-TIA is a composite score of 3 categories: diagnostic stroke
evaluation, secondary stroke prevention, and stroke education. Individual components of the
primary outcome were principally derived from AHA stroke guidelines. Additional outcome
measures include individual analyses of the components of the primary outcome as well as the
complication rate, stroke recurrence rate, transfer rate, patient and provider satisfaction
levels, and a cost-analysis. All outcomes will be assessed at 1 year post-implementation,
with data accruement starting after a 3-month lead in phase.
acute stroke, specifically related to the use of intravenous thrombolysis. Effective urgent
stroke evaluation and secondary stroke prevention is also essential to decrease the risk of
recurrent stroke, however, there have been no studies to date examining the use of telestroke
to improve delivery of non-emergent inpatient stroke care per American Heart Association
(AHA) guidelines.
Currently, access to stroke specialist expertise is limited resulting in significant
disparities in stroke care. Previous publications have identified that patients in rural
areas may receive sub-optimal stroke care that does not follow accepted guideline
recommendations. Telestroke is a cost-effective mechanism to deliver specialist stroke care
to hospitals that do not have in-person stroke consultation available. The aim of
TELECAST-TIA is to determine whether specialist telestroke inpatient rounding improves
guideline-based TIA treatment when compared to non-specialist transient ischemic attack
treatment.
The primary outcome of TELECAST-TIA is a composite score of 3 categories: diagnostic stroke
evaluation, secondary stroke prevention, and stroke education. Individual components of the
primary outcome were principally derived from AHA stroke guidelines. Additional outcome
measures include individual analyses of the components of the primary outcome as well as the
complication rate, stroke recurrence rate, transfer rate, patient and provider satisfaction
levels, and a cost-analysis. All outcomes will be assessed at 1 year post-implementation,
with data accruement starting after a 3-month lead in phase.
Inclusion Criteria:
- Age 18 and above
- Patients with the primary diagnosis of transient ischemic attack evaluated at the
Fairview Ridges Hospital emergency room
- Clinical diagnosis of transient ischemic attack by the treating stroke neurology
service
Exclusion Criteria:
- Patients less than 18 years old
- Patients who leave the hospital against medical advice
- Patients who are felt to have an alternative diagnosis
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201 E Nicollet Blvd
Burnsville, Minnesota 55337
Burnsville, Minnesota 55337
(952) 892-2000
Phone: 612-625-1969
Fairview Ridges Hospital Fairview Ridges Hospital is a 150-bed, Level III Trauma Care facility, offering...
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