The CLOQS Trial - Countdown Lights to Optimize Quality in Stroke

Sunnybrook Health Sciences Centre

Status: Completed

Conditions: Acute Stroke

Treatments: Other: LED stopwatch-clock timers

Study type: Interventional

Funder types: Other

Identifiers

NCT01148602

UTSP Innovation

Details and patient eligibility

About

To reduce door-to-needle times in acute stroke treatment. Using an organizational behaviour intervention (a large stopwatch), we will post a visual cue to remind all parties that "time is brain". We hypothesize that this simple visual cue will improve door-to-CT scan times and door-to-needle treatment times, and thus improve treatment response, and reduce adverse events.

Full description

We will construct a large, "in-your-face" red LED stopwatch-clock that is the intervention. The clock will be attached to the stretcher of patients presenting for hyperacute stroke treatment (consideration of tissue plasminogen activator (tPA) treatment at the moment of their Emergency department arrival. This will act as a constant visual reminder to all team members (physicians, RN's, CT technologists) of the urgency of the situation. The study will be a block randomization, by week of presentation. All patients presenting during "on" weeks will have a stopwatch timer with them during the hyperacute stroke workup. During "off" weeks, the clocks will not be used.

Enrollment: 3,452 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients who present to the emergency room with acute stroke for consideration of treatment with tPA.

Exclusion criteria

• Patients presenting to the emergency room (door time) more than 4.5 hours after symptom onset

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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3,452 participants in 2 patient groups

'Off Clock'

No Intervention group

Description:

Stopwatch timers will NOT be used for "off clock" weeks, so patients presenting with hyperacute stroke will be managed normally without the visual timer.

'On Clock"

Active Comparator group

Description:

LED stopwatch-clock timers will be posted for all patients presenting during "ON clock" weeks. All patients presenting with hyperacute stroke will be managed normally with the addition of a visual stopwatch timer.

Treatment:

Other: LED stopwatch-clock timers