Simple text-messaging intervention is associated with improved door-to-needle times for acute ischemic stroke

Molly M. Burnett, Lara Zimmermann, Zlatan Coralic, Tina Quon, William Whetstone, Anthony S. Kim

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background and Purpose - Timely administration of intravenous tissue-type plasminogen activator (IV tPA) is associated with improved outcomes for acute ischemic stroke; yet, developing processes to consistently provide prompt treatment remains a challenge. We developed and evaluated a simple quality improvement intervention designed to improve doorto- needle (DTN) times for resident-led Code Stroke teams at an academic medical center.

Methods - We evaluated a simple text-messaging based intervention with real-time feedback to improve DTN times for intravenous tissue-type plasminogen activator. We used the rank-sum test and linear regression to evaluate for a change in DTN times that was temporally associated with the rollout of the intervention.

Results - A total of 202 patients received intravenous tissue-type plasminogen activator; 94 preintervention and 108 postintervention. The median DTN time was significantly lower in the postintervention period (56 minutes [interquartile range 44-71] versus 82 minutes [IQR 68-103], P<0.0001) and a significantly higher proportion of patients were treated within 60 minutes (61% versus 16%, P<0.001).

Conclusions - A simple real-time text-messaging intervention was associated with a significant improvements in DTN times for acute ischemic stroke.

Original languageEnglish (US)
Pages (from-to)3714-3716
Number of pages3
Issue number12
StatePublished - Jan 1 2014
Externally publishedYes


  • Door-to-treatment time
  • Quality improvement
  • Stroke
  • Thrombolytic therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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