Abstract
Background and Purpose: We established triage and bypass transportation systems for thrombolytic therapy in the community and repeatedly monitored their quality by clinical indicators.
Methods: Modified Cincinnati Prehospital Stroke Scale, named Maria Prehospital Stroke Scale (MPSS), and a decision tree linked with the MPSS score were developed for stroke bypass-transportation in Kawasaki City. Quality-assurance monitoring was repeatedly performed every six months.
Results: A total of 174 patients were transferred by the stroke bypass-transportation system. 145 patients (83.3%) were transferred to the stroke center in Kawasaki city, but 21 (12.1%) were transferred to the hospitals in the neighboring cities. Thrombolytic therapy was performed in 36 patients (23.8%). Mean onset-to-injection time was shortened by 10 minutes and the rate of modified Rankin scale score less than 2 was 42.9%.
Conclusion: Quality-assurance monitoring for thrombolytic therapy in the community is feasible and useful for improving quality of care without regional difference.
