QLTI-11. IMPROVING ACUTE STROKE RESPONSE AT A COMPREHENSIVE CANCER CENTER: A MULTIDISCIPLINARY HOSPITAL-BASED QUALITY IMPROVEMENT PROJECT

Abstract BACKGROUND Stroke is common in patients with malignancy, but cancer treatment have contraindications to intravenous (IV) tissue plasminogen activator (tPA). Advancements endovascular therapy (EVT) has expanded options for acute stroke management . Memorial Sloan Kettering (MSK) a center without public emergency room. Acute occurs inpatient or urgent care (UCC). We determined need rapid identification and strokes our patient population. METHODS developed multidisciplinary Pathway relying on activation of hospital’s response team (RRT), neurology, radiology, nursing support, escort services, pharmacy. initiated hospital-wide education around symptoms the pathway. All activations are reviewed by Neurology bi-weekly real-time feedback. Metrics include times symptom (“door time” = UCC check discovery inpatients), evaluation, head computed tomography (CT), labs, administration IV tPA. Times compared 2016 institutional baseline data National Institute Neurological Disorders (NINDS) benchmarks. RESULTS Since implementation pathway (6/11/2018) through Q1 2022 (3/31/2022), there were 551 activations, 13 tPA administrations, 48 transferred comprehensive consideration EVT. Average 2021 door-to-evaluation time: 8 mins (baseline: 18 mins, NINDS: 10 mins), door-to-stroke team: 11 unknown, 15 door-to-CT: 33 (Baseline: 95 25min), door-to-CT interpretation: 34 251 45 door-to-labs: 50 min), door-to-IV tPA: 62 60min). DISCUSSION The population at MSK distinct from most hospitals. Patients higher incidence unlikely candidates intervention. Inter-professional collaboration resulted early oncology consistent NINDS