TY  - JOUR
A1  - Gabriel, Katharina M. A.
A1  - Jírů-Hillmann, Steffi
A1  - Kraft, Peter
A1  - Selig, Udo
A1  - Rücker, Victoria
A1  - Mühler, Johannes
A1  - Dötter, Klaus
A1  - Keidel, Matthias
A1  - Soda, Hassan
A1  - Rascher, Alexandra
A1  - Schneider, Rolf
A1  - Pfau, Mathias
A1  - Hoffmann, Roy
A1  - Stenzel, Joachim
A1  - Benghebrid, Mohamed
A1  - Goebel, Tobias
A1  - Doerck, Sebastian
A1  - Kramer, Daniela
A1  - Haeusler, Karl Georg
A1  - Volkmann, Jens
A1  - Heuschmann, Peter U.
A1  - Fluri, Felix
T1  - Two years' experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)
JF  - BMC Neurology
N2  - Background 
Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years' experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. 

Methods 
The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. 

Results 
Overall, 7881 patients were included (mean age 74.6 years +/- 12.8; 48.4% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31%), mainly in secondary stroke prevention; b) improvement over time (44%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. 

Conclusion 
The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals.
KW  - pilot project
KW  - care tempis
KW  - ischemic stroke
KW  - thrombolysis
KW  - areas
KW  - time
KW  - hospitals
KW  - mortality
KW  - outcomes
KW  - quality
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-229214
VL  - 20
ER  -