System failing stroke patients, exercise finds

Taranaki's public hospitals have used Toyota's acclaimed production systems to work out how efficiently they are looking after their stroke patients.

The results: Not well.

In the major fact-finding exercise earlier this year, a team of six Taranaki DHB managers followed 20 stroke patients through their hospital care.

The team found that of the six key objectives for stroke patients, under the national 2003 Life After Stroke guidelines, only two were currently being met, said Wendy Langlands, the older persons health and rehabilitation manager, who headed the team.

The assessment, called the Lean Thinking Project and based on Toyota's production systems which have been in use for 40 years, was aimed at improving productivity, systems and procedures.

"We were looking at reducing waste and improving the flow," Ms Langlands said.

On average, a stroke patient arrives at base hospital or Hawera Hospital every second day.

"We were seeing a lot of waiting around. We think we can improve the pathways considerably," she said.

While the Emergency Department was generally seeing stroke patients within 10 minutes to half an hour of arrival, 50 per cent remained in ED on average for 8 1/2 hours rather than the recommended six hours.

And while stroke patients are ideally supposed to be treated in ward 1, most of the 20 patients were sent to different wards within the hospital, then being transferred back to ward 1.

There was no consistency in when the patients were given diagnostic CT scans.

The guidelines recommend a cat scan within 48 hours.

The team has recommended that under the new "stroke pathway", expected to begin next month, patients will spend less than six hours in ED.

All stroke patients will remain in the hands of the same multi-disciplinary team who will care for them throughout their hospital stay in ward 1, Ms Langlands said.

- © Fairfax NZ News