Simulation training for emergency teams to manage acute ischemic stroke by telemedicine

Richard, Sébastien; Mione, Gioia; Varoqui, Claude; Vezain, Arnaud; Brunner, Arielle; Bracard, Serge; Debouverie, M.; Braun, Marc

doi:10.1097/md.0000000000003924

Cited by 23 publications

(12 citation statements)

References 20 publications

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“…Several acute neurologic conditions would easily lend themselves to potential scenarios (►Table 2). [13][14][15] A common mistake is to equate the purpose of simulation in neurology with simulation of an abnormal neurologic examination. No currently available technology can, in any way, replicate abnormal neurologic findings, and even high-fidelity mannequins can only provide changes in pupils and "convulsions," which look embarrassingly artificial.…”

Section: Building and Executing Scenarios In Neurologymentioning

confidence: 99%

A Future for Simulation in Acute Neurology

Wijdicks

Hocker

2018

Semin Neurol

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Acute neurologic (and potentially disability prone) conditions are rarely taught and, if so, at the bedside and usually after the fact. Simulation training offers a realistic environment to teach rapid-fire decision making, how to take charge, and how best to approach a deteriorating, acutely ill neurologic patient.Simulating acute neurology is a newly emerging educational program. Proven principles of simulation, which may include teaching technical skills, can be applied to acute neurology (and neurointensive care). Communication skills pertaining to catastrophic neurologic injury with all its ethical ramifications can be taught and practiced. There is a growing need for well-designed, tested teaching scenarios and a need to validate this approach. This review provides an overview of the potential opportunities available in medical institutions with a simulation center.

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Section: Building and Executing Scenarios In Neurologymentioning

confidence: 99%

A Future for Simulation in Acute Neurology

Wijdicks

Hocker

2018

Semin Neurol

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“…12,13 Simulation training for stroke and other neurological emergencies assessing trainee confidence and/or medical knowledge before and after participating in the program have been shown to be effective. 14,15 Our study model evaluated objective data directly related to patient care. There is strong evidence of improved neurological outcomes with shorter IV-tPA treatment times from symptom onset in AIS patients.…”

Section: Discussionmentioning

confidence: 99%

Stroke Simulation Improves Acute Stroke Management: A Systems-Based Practice Experience

Mehta

Strauß

Beland

et al. 2018

Journal of Graduate Medical Education

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“…The emergency department staff could be trained as part of continued professional training which would not lead to a loss of working time. Material for simulation training, as well as the trainers’ time, was provided free of charge by our university center ( 24 ). Remuneration of neurologists to ensure the dedicated 24/7 medical service is specific to the French public healthcare system.…”

Section: Discussionmentioning

confidence: 99%

Implementation and Evaluation of an Economic Model for Telestroke: Experience from Virtuall, France

et al. 2017

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BackgroundTelestroke is recognized as a safe and time-efficient way of treating stroke patients. However, admission centers (spokes) are subject to financial charges which can make them reluctant to join the system. We implemented and assessed an economic model supporting our telestroke system, Virtuall, France, which includes one expert center (hub) and six spokes.MethodsThe model is based on payment for the expertise provided by the hub, distribution of charges related to telemedicine according to the fees perceived by the spokes, and transfer of patients between the spokes and the hub. We performed a cost–benefit analysis for all patients included in Virtuall from January 2014 to December 2015 to assess the economic balance in each center.Results321 patients were prospectively included in the study. Application of the economic model resulted in overall financial balance with funding of a dedicated medical service in the hub, and reduced costs directly related to telestroke by an average of 10% in the spokes. The conditions generating the highest costs for the spokes were: a patient returning from the hub for re-hospitalization (mean cost of $1,995/patient); management of patients treated by intravenous thrombolysis without transfer to the hub (mean cost of $2,075/patient). The most favorable financial condition for the spokes remained simple transfer of patients to the hub and no return (mean cost of $329/patient).ConclusionWe describe an economic model which can be applied to any telestroke system to ensure the optimal balance between hub and spoke centers.

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Simulation training for emergency teams to manage acute ischemic stroke by telemedicine

Abstract: Supplemental Digital Content is available in the text

Cited by 23 publications

References 20 publications

A Future for Simulation in Acute Neurology

A Future for Simulation in Acute Neurology

Stroke Simulation Improves Acute Stroke Management: A Systems-Based Practice Experience

Implementation and Evaluation of an Economic Model for Telestroke: Experience from Virtuall, France

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