Room to Improve Door-in-Door-out Times for Interhospital Acute Stroke Transfers

For some patients with acute stroke, interhospital transfer is required to access time-sensitive interventions or regionalized neurosurgical and neurocritical care services. The Joint Commission and Brain Attack Coalition have recommended a target door-in-door-out (DIDO) time (the interval between hospital arrival and transfer out of the emergency department to another hospital) of ≤120 minutes, but limited data have been available on this important process metric.

Based on data from the U.S.-based Get With The Guidelines–Stroke registry, investigators identified 108,913 patients treated at 1925 hospitals that required interhospital transfer for acute ischemic stroke or hemorrhagic stroke from 2019 through 2021. The overall median DIDO time …