Background
The Australian National Targets for stroke were announced in August 2023. We focused on the target of a National median thrombolysis door to needle time of <60 minutes and developed a plan to improve our performance.
Methods/Results
Baseline data (April 2023–March 2024) showed a median door-to-needle time of 55 minutes, with 66.7% of thrombolysis cases completed within 60 minutes. We implemented a reward/recognition system for the entire team involved in each perfusion case. The team consisted of ambulance officers, Emergency Department medical officer, medical Registrar, medical intern, radiographer, NSW Telestroke Service Neurologist and in hours the Rural Stroke care Coordinator or Telestroke Clinical Nurse Specialist. In each thrombolysis case achieving a door-to-needle time of 45 minutes or less everyone involved in the case received a certificate with their name, the date and the door to needle time on it and they also received a gold lapel pin.
Results from the following year (April 2024–March 2025) showed a significantly improved median door-to-needle time of 44.5 minutes, with 83.3% of cases completed within 60 minutes—a 10.5-minute reduction and a 16.6% increase in cases treated under the target time. In a qualitative survey sent to staff words they used to describe how this reward and recognition system made them feel were: proud, competitive, rivalry, appreciated, acknowledged, great, and valued.
Conclusion
A simple reward and recognition system has improved our median door to needle time and has made the team members feel appreciated, acknowledged and valued.