Helsinki Stroke model reduced stroke thrombolysis delay from 70 to 31 minutes in Christchurch, demonstrating transferability with ‘real-world’ resources. (P4.248)

Objective: Christchurch Hospital is a tertiary hospital in New Zealand supported by 5 general neurologists with after-hours services provided mainly by onsite non-neurology medical residents. We assessed the transferability and impact on stroke thrombolysis door-to-needle time (DNT) of the Helsinki Stroke model in Christchurch Hospital, Christchurch, New Zealand. Background: In 2015 a rapid access ‘code stroke’ page with patient detail pre-notification by ambulance paramedic was introduced together with administration of alteplase on or by the CT scanner. In May 2017 direct transfer to CT on ambulance stretcher for ‘code stroke’ patients with treatable neurological deficits arriving at the emergency department was introduced. Design/Methods: We analyzed the impact on DNT at Christchurch Hospital with the staged introduction of the components of the Helsinki Stroke model from 2015 to July 2017. Results: Nineteen patients have been treated with alteplase in the second half (since July) of 2017, of which 11 (58%) in-hours (8 am to 5 pm on non-public holiday weekdays) and 8 (42%) after-hours. In 2015 there were 42 (16 (38%) in-hours, 26 (62%) after-hours) thrombolyzed patients. The overall median (interquartile range) DNT in minutes was reduced from 72 (61–94) in 2015 to 35 (30–45) in 2017. DNT reduced from 70 (60–95) to 31 (29–40) minutes for in-hours and from 74 (61–94) to 43 (32–56) minutes for after-hours patients (all p-values Conclusions: The Helsinki Stroke model is transferrable with real-world resources and reduced stroke thrombolysis delay in Christchurch by over 50%. Disclosure: Dr. Coleman has nothing to disclose. Dr. Wright has nothing to disclose. Dr. Mason has nothing to disclose. Dr. Reimers has nothing to disclose. Dr. Duncan has nothing to disclose. Dr. Griffiths has nothing to disclose. Dr. Hurrell has nothing to disclose. Dr. Dixon has nothing to disclose. Dr. Meretoja has nothing to disclose. Dr. Fink has nothing to disclose. Dr. Wu has nothing to disclose.