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Helsinki University Central Hospital achieved a median door-to-needle time of 20 minutes for acute stroke patients arriving by ambulance, by implementing 12 separate interventions (NEJM JW Emerg Med Aug 17 2012). In May 2012, a hospital in Australia implemented three Helsinki interventions during weekday office hours — stroke team activation based on emergency medical services notification, direct patient transfer from ambulance to computed tomography (CT), and initiation of tissue plasminogen activator in the CT room; these authors prospectively analyzed the effect of these interventions on door-to-needle time.
Median door-to-needle time decreased from 61 minutes during the year before the intervention (85 patients) to 46 minutes during the…