Abstract 189: An Expedited Transfer Protocol Improves Door In Door Out Times

BackgroundRapid reperfusion with mechanical thrombectomy for ischemic stroke secondary to large vessel occlusion leads to significant reduction in morbidity and mortality. DIDO time is an important metric for stroke centers without on‐site mechanical thrombectomy. Delays in treatment can occur when patients present at a Primary Stroke Center (PSC) then require transfer to the CSC for MT. Our system Comprehensive Stroke Center (CSC) receives patients from 2 of our systems PSC's. In order to expedite care an expedited transfer protocol was implemented.Purpose: The goal of this work is to decrease the time at the PSC, known as door‐in‐door‐out (DIDO) and decrease overall time from patient presentation to treatment with thrombectomy, known as door to groin time (DTG).Methods: Patients are screened at triage by a PSC emergency department provider for the following: aphasia, gaze preference, or neglect with unilateral weakness within 24 hours of last known normal. If these criteria are present, the emergency department provider contacts the CSC transfer center to initiate the expedited transfer process, which begins moving transfer resources to the PSC while clinical work‐up continues. This expedited early transfer process was implemented in January 2021. Transfers for MT during the 12‐month period before and after the implementation of the expedited transfer process were analyzed.Results: Mean DIDO was lower when expedited protocol was utilized (99 min vs. 137 min respectively, (p=.017)). Mean DTG was unchanged (27 min vs. 37 min respectively, (p = 0.067)).Conclusions: Use of the expedited transfer process allows transfer resources to begin moving to the patient with a suspected LVO in parallel with ongoing evaluation, resulting in faster DIDO and times leading to faster treatment aimed at reducing stroke morbidity and mortality.