Implementation of stroke teams and simulation training shortened process times in a regional stroke network—A network-wide prospective trial
To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and val...
Saved in:
| Published in | PloS one Vol. 12; no. 12; p. e0188231 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
05.12.2017
Public Library of Science (PLoS) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1932-6203 1932-6203 |
| DOI | 10.1371/journal.pone.0188231 |
Cover
| Abstract | To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units.
We recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings.
The intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8-60,0, n = 122) to 31,0 (IQR 24,0-42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds.
The composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks. |
|---|---|
| AbstractList | Background
To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units.
Methods
We recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings.
Results
The intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8–60,0, n = 122) to 31,0 (IQR 24,0–42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds.
Conclusions
The composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks. To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units.BACKGROUNDTo meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units.We recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings.METHODSWe recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings.The intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8-60,0, n = 122) to 31,0 (IQR 24,0-42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds.RESULTSThe intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8-60,0, n = 122) to 31,0 (IQR 24,0-42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds.The composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks.CONCLUSIONSThe composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks. Background To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units. Methods We recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings. Results The intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8–60,0, n = 122) to 31,0 (IQR 24,0–42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds. Conclusions The composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks. To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units. We recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings. The intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8-60,0, n = 122) to 31,0 (IQR 24,0-42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds. The composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks. To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the breadth of stroke-ready hospitals and 2) to find new ways to train the personnel treating patients with acute stroke. We aimed to implement and validate a composite intervention of a stroke team algorithm and simulation-based stroke team training as an effective quality initiative in our regional interdisciplinary neurovascular network consisting of 7 stroke units. We recorded door-to-needle times of all consecutive stroke patients receiving thrombolysis at seven stroke units for 3 months before and after a 2 month intervention which included setting up a team-based stroke workflow at each stroke unit, a train-the-trainer seminar for stroke team simulation training and a stroke team simulation training session at each hospital as well as a recommendation to take up regular stroke team trainings. The intervention reduced the network-wide median door-to-needle time by 12 minutes from 43,0 (IQR 29,8-60,0, n = 122) to 31,0 (IQR 24,0-42,0, n = 112) minutes (p < 0.001) and substantially increased the share of patients receiving thrombolysis within 30 minutes of hospital arrival from 41.5% to 59.6% (p < 0.001). Stroke team training participants stated a significant increase in knowledge on the topic of acute stroke care and in the perception of patient safety. The overall course concept was regarded as highly useful by most participants from different professional backgrounds. The composite intervention of a binding team-based algorithm and stroke team simulation training showed to be well-transferable in our regional stroke network. We provide suggestions and materials for similar campaigns in other stroke networks. |
| Audience | Academic |
| Author | Menon, Sanjay Kuhlmann, Andrea Henke, Christian Hartmetz, Ann-Kathrin Thonke, Sven Weidauer, Stefan Buchkremer, Martin Rostek, Peter Tahtali, Damla Bohmann, Ferdinand Stegemann, André Meyding-Lamadé, Uta Abruscato, Mario Kurka, Natalia Steinmetz, Helmuth Reihs, Anke Singer, Oliver Pfeilschifter, Waltraud Todorova-Rudolph, Anelia Misselwitz, Björn |
| AuthorAffiliation | 7 Department of Neurology, Sankt Katharinen-Krankenhaus, Frankfurt am Main, Germany 5 Department of Neurology, Krankenhaus Nordwest, Frankfurt am Main, Germany 4 Department of Neurology, Klinikum Hanau, Hanau, Germany 2 NICU Nursing Staff, University Hospital Frankfurt, Frankfurt am Main, Germany 9 Geschäftsstelle Qualitätssicherung Hessen (GQH), Eschborn, Frankfurt, Germany 6 Department of Neurology, Helios HSK Wiesbaden, Wiesbaden, Germany 1 Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany 3 Department of Neurology, Vitos Weil-Lahn, Weilmünster, Germany 8 Department of Neurology, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany University of Münster, GERMANY |
| AuthorAffiliation_xml | – name: 3 Department of Neurology, Vitos Weil-Lahn, Weilmünster, Germany – name: 4 Department of Neurology, Klinikum Hanau, Hanau, Germany – name: 6 Department of Neurology, Helios HSK Wiesbaden, Wiesbaden, Germany – name: 5 Department of Neurology, Krankenhaus Nordwest, Frankfurt am Main, Germany – name: 7 Department of Neurology, Sankt Katharinen-Krankenhaus, Frankfurt am Main, Germany – name: 2 NICU Nursing Staff, University Hospital Frankfurt, Frankfurt am Main, Germany – name: 9 Geschäftsstelle Qualitätssicherung Hessen (GQH), Eschborn, Frankfurt, Germany – name: 8 Department of Neurology, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany – name: University of Münster, GERMANY – name: 1 Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany |
| Author_xml | – sequence: 1 givenname: Damla surname: Tahtali fullname: Tahtali, Damla – sequence: 2 givenname: Ferdinand surname: Bohmann fullname: Bohmann, Ferdinand – sequence: 3 givenname: Natalia surname: Kurka fullname: Kurka, Natalia – sequence: 4 givenname: Peter surname: Rostek fullname: Rostek, Peter – sequence: 5 givenname: Anelia surname: Todorova-Rudolph fullname: Todorova-Rudolph, Anelia – sequence: 6 givenname: Martin surname: Buchkremer fullname: Buchkremer, Martin – sequence: 7 givenname: Mario surname: Abruscato fullname: Abruscato, Mario – sequence: 8 givenname: Ann-Kathrin surname: Hartmetz fullname: Hartmetz, Ann-Kathrin – sequence: 9 givenname: Andrea surname: Kuhlmann fullname: Kuhlmann, Andrea – sequence: 10 givenname: Christian surname: Henke fullname: Henke, Christian – sequence: 11 givenname: André surname: Stegemann fullname: Stegemann, André – sequence: 12 givenname: Sanjay surname: Menon fullname: Menon, Sanjay – sequence: 13 givenname: Björn surname: Misselwitz fullname: Misselwitz, Björn – sequence: 14 givenname: Anke surname: Reihs fullname: Reihs, Anke – sequence: 15 givenname: Stefan surname: Weidauer fullname: Weidauer, Stefan – sequence: 16 givenname: Sven surname: Thonke fullname: Thonke, Sven – sequence: 17 givenname: Uta surname: Meyding-Lamadé fullname: Meyding-Lamadé, Uta – sequence: 18 givenname: Oliver surname: Singer fullname: Singer, Oliver – sequence: 19 givenname: Helmuth surname: Steinmetz fullname: Steinmetz, Helmuth – sequence: 20 givenname: Waltraud orcidid: 0000-0001-6935-8842 surname: Pfeilschifter fullname: Pfeilschifter, Waltraud |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29206838$$D View this record in MEDLINE/PubMed |
| BookMark | eNqNk9lq3DAUhk1JaZb2DUprKJT2YqaSZXnpRSGELgOBQLdbIUvHM0pkyZHkpLnrE_SqT9gnqVzPhEwIJfjCWr7zn01nP9kx1kCSPMVojkmJ35zawRmu5308niNcVRnBD5I9XJNsVmSI7NxY7yb73p8iRElVFI-S3azOUFGRai_5teh6DR2YwIOyJrVt6oOzZ5AG4J1PuZGpV92gp-vguDLKLFO_si6AAZn2zgrwPg2qA58qk_LUwTLCXG-kDIRL687-_Px9uFnPLpWE0db3IIK6iP6c4vpx8rDl2sOT9f8g-fbh_dejT7Pjk4-Lo8PjmSjqLMwkEVVR8waTBhUC5VVVNLImuJB11iBeZLSkskUFgarBeQZVAXEvswzVFSY5IgfJ80m319azdSk9w3VJUFbinEZiMRHS8lPWO9Vxd8UsV-zfgXVLxl1QQgNraYOa6FsgEHlbtxwLVLU5SFnnlFMRteikNZieX11yra8FMWJjNzchsLGbbN3NaPduHeXQdCBF7JLjeiuY7RujVmxpLxgtcUFjLgfJq7WAs-cD-MA65QVozQ3YYco3p2WJR18vbqF3V2VNLXlMXJnWRr9iFGWHFJc0J3VdR2p-BxU_CZ0SMcNWxfMtg9dbBpEJ8CMs-eA9W3z5fH_25Ps2-_IGuwKuw8pbPYxv2W-Dz25W-rrEm0GJQD4BIj5Z76C9bwff3jITapq0cZL0_43_Ak9ZP30 |
| CitedBy_id | crossref_primary_10_1080_08998280_2019_1632779 crossref_primary_10_1177_2516608520984276 crossref_primary_10_3389_fneur_2021_665808 crossref_primary_10_1016_j_jocn_2020_02_002 crossref_primary_10_1186_s41077_024_00283_6 crossref_primary_10_1186_s42466_023_00245_9 crossref_primary_10_18700_jnc_210010 crossref_primary_10_1136_bmjopen_2024_086413 crossref_primary_10_1136_bmjoq_2022_002107 crossref_primary_10_1097_TA_0000000000002073 crossref_primary_10_1186_s12909_024_06438_3 crossref_primary_10_3389_fneur_2019_00969 crossref_primary_10_32749_nucleodoconhecimento_com_br_saude_urgencia_e_emergencia crossref_primary_10_1007_s12028_018_0629_2 crossref_primary_10_1097_SIH_0000000000000740 crossref_primary_10_1111_ene_15093 crossref_primary_10_1177_15910199221113902 crossref_primary_10_3389_fstro_2024_1382608 crossref_primary_10_1371_journal_pone_0288207 crossref_primary_10_1111_ane_13476 crossref_primary_10_2196_43416 crossref_primary_10_1016_j_nic_2018_06_010 crossref_primary_10_1136_bmjopen_2021_055461 |
| Cites_doi | 10.1148/radiol.2016160204 10.1161/STROKEAHA.107.487967 10.1136/bmj.320.7237.785 10.1111/j.1747-4949.2011.00585.x 10.1161/STROKEAHA.108.543561 10.1016/j.bpa.2015.02.002 10.1056/NEJMoa0804656 10.1161/CIRCOUTCOMES.111.000095 10.1161/STROKEAHA.114.007170 10.1186/1471-2288-7-30 10.1016/S0140-6736(14)60584-5 10.1212/WNL.0b013e31825d6011 10.1016/S0140-6736(16)00163-X 10.1007/s00115-016-0162-5 |
| ContentType | Journal Article |
| Copyright | COPYRIGHT 2017 Public Library of Science 2017 Tahtali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2017 Tahtali et al 2017 Tahtali et al |
| Copyright_xml | – notice: COPYRIGHT 2017 Public Library of Science – notice: 2017 Tahtali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2017 Tahtali et al 2017 Tahtali et al |
| DBID | AAYXX CITATION NPM IOV ISR 3V. 7QG 7QL 7QO 7RV 7SN 7SS 7T5 7TG 7TM 7U9 7X2 7X7 7XB 88E 8AO 8C1 8FD 8FE 8FG 8FH 8FI 8FJ 8FK ABJCF ABUWG AEUYN AFKRA ARAPS ATCPS AZQEC BBNVY BENPR BGLVJ BHPHI C1K CCPQU D1I DWQXO FR3 FYUFA GHDGH GNUQQ H94 HCIFZ K9. KB. KB0 KL. L6V LK8 M0K M0S M1P M7N M7P M7S NAPCQ P5Z P62 P64 PATMY PDBOC PHGZM PHGZT PIMPY PJZUB PKEHL PPXIY PQEST PQGLB PQQKQ PQUKI PRINS PTHSS PYCSY RC3 7X8 5PM ADTOC UNPAY DOA |
| DOI | 10.1371/journal.pone.0188231 |
| DatabaseName | CrossRef PubMed Gale In Context: Opposing Viewpoints Gale In Context: Science ProQuest Central (Corporate) Animal Behavior Abstracts Bacteriology Abstracts (Microbiology B) Biotechnology Research Abstracts Nursing & Allied Health Database Ecology Abstracts Entomology Abstracts (Full archive) Immunology Abstracts Meteorological & Geoastrophysical Abstracts Nucleic Acids Abstracts Virology and AIDS Abstracts Agricultural Science Collection Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) ProQuest Pharma Collection Public Health Database Technology Research Database ProQuest SciTech Collection ProQuest Technology Collection ProQuest Natural Science Journals Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) Materials Science & Engineering Collection ProQuest Central (Alumni) ProQuest One Sustainability ProQuest Central UK/Ireland Advanced Technologies & Computer Science Collection Agricultural & Environmental Science Collection ProQuest Central Essentials Biological Science Collection ProQuest Central Technology Collection Natural Science Collection Environmental Sciences and Pollution Management ProQuest One Community College ProQuest Materials Science Collection ProQuest Central Korea Engineering Research Database Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Central Student AIDS and Cancer Research Abstracts SciTech Premium Collection ProQuest Health & Medical Complete (Alumni) Materials Science Database Nursing & Allied Health Database (Alumni Edition) Meteorological & Geoastrophysical Abstracts - Academic ProQuest Engineering Collection Biological Sciences Agriculture Science Database Health & Medical Collection (Alumni Edition) Medical Database Algology Mycology and Protozoology Abstracts (Microbiology C) Biological Science Database Engineering Database Nursing & Allied Health Premium Advanced Technologies & Aerospace Database ProQuest Advanced Technologies & Aerospace Collection Biotechnology and BioEngineering Abstracts Environmental Science Database Materials Science Collection ProQuest Central Premium ProQuest One Academic Publicly Available Content Database ProQuest Health & Medical Research Collection ProQuest One Academic Middle East (New) ProQuest One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Applied & Life Sciences ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central China Engineering Collection Environmental Science Collection Genetics Abstracts MEDLINE - Academic PubMed Central (Full Participant titles) Unpaywall for CDI: Periodical Content Unpaywall DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef PubMed Agricultural Science Database Publicly Available Content Database ProQuest Central Student ProQuest Advanced Technologies & Aerospace Collection ProQuest Central Essentials Nucleic Acids Abstracts SciTech Premium Collection ProQuest Central China Environmental Sciences and Pollution Management ProQuest One Applied & Life Sciences ProQuest One Sustainability Health Research Premium Collection Meteorological & Geoastrophysical Abstracts Natural Science Collection Health & Medical Research Collection Biological Science Collection ProQuest Central (New) ProQuest Medical Library (Alumni) Engineering Collection Advanced Technologies & Aerospace Collection Engineering Database Virology and AIDS Abstracts ProQuest Biological Science Collection ProQuest One Academic Eastern Edition Agricultural Science Collection ProQuest Hospital Collection ProQuest Technology Collection Health Research Premium Collection (Alumni) Biological Science Database Ecology Abstracts ProQuest Hospital Collection (Alumni) Biotechnology and BioEngineering Abstracts Environmental Science Collection Entomology Abstracts Nursing & Allied Health Premium ProQuest Health & Medical Complete ProQuest One Academic UKI Edition Environmental Science Database ProQuest Nursing & Allied Health Source (Alumni) Engineering Research Database ProQuest One Academic Meteorological & Geoastrophysical Abstracts - Academic ProQuest One Academic (New) Technology Collection Technology Research Database ProQuest One Academic Middle East (New) Materials Science Collection ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Health & Nursing ProQuest Natural Science Collection ProQuest Pharma Collection ProQuest Central ProQuest Health & Medical Research Collection Genetics Abstracts ProQuest Engineering Collection Biotechnology Research Abstracts Health and Medicine Complete (Alumni Edition) ProQuest Central Korea Bacteriology Abstracts (Microbiology B) Algology Mycology and Protozoology Abstracts (Microbiology C) Agricultural & Environmental Science Collection AIDS and Cancer Research Abstracts Materials Science Database ProQuest Materials Science Collection ProQuest Public Health ProQuest Nursing & Allied Health Source ProQuest SciTech Collection Advanced Technologies & Aerospace Database ProQuest Medical Library Animal Behavior Abstracts Materials Science & Engineering Collection Immunology Abstracts ProQuest Central (Alumni) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic Agricultural Science Database PubMed |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: UNPAY name: Unpaywall url: https://proxy.k.utb.cz/login?url=https://unpaywall.org/ sourceTypes: Open Access Repository – sequence: 4 dbid: 8FG name: ProQuest Technology Collection url: https://search.proquest.com/technologycollection1 sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Sciences (General) |
| DocumentTitleAlternate | Stroke team and simulation training shorten door-to-needle time |
| EISSN | 1932-6203 |
| ExternalDocumentID | 1973027145 oai_doaj_org_article_f5b0b16dc0ec4f9fa1c08f4edd945a5c 10.1371/journal.pone.0188231 PMC5716597 A517543999 29206838 10_1371_journal_pone_0188231 |
| Genre | Journal Article |
| GeographicLocations | Germany |
| GeographicLocations_xml | – name: Germany |
| GrantInformation_xml | – fundername: ; |
| GroupedDBID | --- 123 29O 2WC 53G 5VS 7RV 7X2 7X7 7XC 88E 8AO 8C1 8CJ 8FE 8FG 8FH 8FI 8FJ A8Z AAFWJ AAUCC AAWOE AAYXX ABDBF ABIVO ABJCF ABUWG ACGFO ACIHN ACIWK ACPRK ACUHS ADBBV ADRAZ AEAQA AENEX AEUYN AFKRA AFPKN AFRAH AHMBA ALMA_UNASSIGNED_HOLDINGS AOIJS APEBS ARAPS ATCPS BAWUL BBNVY BCNDV BENPR BGLVJ BHPHI BKEYQ BPHCQ BVXVI BWKFM CCPQU CITATION CS3 D1I D1J D1K DIK DU5 E3Z EAP EAS EBD EMOBN ESTFP ESX EX3 F5P FPL FYUFA GROUPED_DOAJ GX1 HCIFZ HH5 HMCUK HYE IAO IEA IGS IHR IHW INH INR IOV IPY ISE ISR ITC K6- KB. KQ8 L6V LK5 LK8 M0K M1P M48 M7P M7R M7S M~E NAPCQ O5R O5S OK1 OVT P2P P62 PATMY PDBOC PHGZM PHGZT PIMPY PJZUB PPXIY PQGLB PQQKQ PROAC PSQYO PTHSS PUEGO PV9 PYCSY RNS RPM RZL SV3 TR2 UKHRP WOQ WOW ~02 ~KM ALIPV IPNFZ NPM RIG BBORY 3V. 7QG 7QL 7QO 7SN 7SS 7T5 7TG 7TM 7U9 7XB 8FD 8FK AZQEC C1K DWQXO FR3 GNUQQ H94 K9. KL. M7N P64 PKEHL PQEST PQUKI PRINS RC3 7X8 5PM ACCTH ADTOC AFFHD BBTPI UNPAY - 02 AAPBV ABPTK ADACO BBAFP KM |
| ID | FETCH-LOGICAL-c692t-d3c869ab13b06c04886bd9316d92b0a62575df063e8b142e86e5dfd2209813403 |
| IEDL.DBID | M48 |
| ISSN | 1932-6203 |
| IngestDate | Fri Nov 26 17:22:40 EST 2021 Tue Oct 14 19:07:00 EDT 2025 Wed Oct 29 12:11:27 EDT 2025 Tue Sep 30 16:55:04 EDT 2025 Mon Sep 08 16:12:04 EDT 2025 Tue Oct 07 07:46:52 EDT 2025 Mon Oct 20 22:24:44 EDT 2025 Mon Oct 20 16:38:02 EDT 2025 Thu Oct 16 14:57:44 EDT 2025 Thu Oct 16 14:03:07 EDT 2025 Thu May 22 21:22:00 EDT 2025 Tue Aug 05 11:47:50 EDT 2025 Wed Oct 01 01:24:19 EDT 2025 Thu Apr 24 23:04:28 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 12 |
| Language | English |
| License | This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. cc-by Creative Commons Attribution License |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c692t-d3c869ab13b06c04886bd9316d92b0a62575df063e8b142e86e5dfd2209813403 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: FB received travel grants and speaker’s honoraria from Boehringer Ingelheim and Stryker Neurovascular; SW received speaker’s honoraria from Bayer Healthcare, Novartis, Bracco, b.e. Imaging GmbH, Merck Serono and consultant fees from Actelion; ST received speaker’s honoraria from UCB, Daiichi Sankyo and Bial and consultant fees from UCB and TEVA; UML received speaker’s honoraria from Bayer Health Care, Pfizer, Novartis, Genzyme, Roche, Merck Serono, Biogen Idec, Sanofi-Aventis, TEVA Pharma, Boehringer Ingelheim; HS received speaker’s honoraria from Bayer, Boehringer Ingelheim and Sanofi-Aventis; and WP received speaker’s honoraria from Boehringer Ingelheim, Stryker Neurovascular, research funding from Stryker Neurovascular, Novartis and consultant fees from Sanofi-Aventis. This does not alter our adherence to PLOS ONE policies on sharing data and materials. |
| ORCID | 0000-0001-6935-8842 |
| OpenAccessLink | http://journals.scholarsportal.info/openUrl.xqy?doi=10.1371/journal.pone.0188231 |
| PMID | 29206838 |
| PQID | 1973027145 |
| PQPubID | 1436336 |
| PageCount | e0188231 |
| ParticipantIDs | plos_journals_1973027145 doaj_primary_oai_doaj_org_article_f5b0b16dc0ec4f9fa1c08f4edd945a5c unpaywall_primary_10_1371_journal_pone_0188231 pubmedcentral_primary_oai_pubmedcentral_nih_gov_5716597 proquest_miscellaneous_1973457711 proquest_journals_1973027145 gale_infotracmisc_A517543999 gale_infotracacademiconefile_A517543999 gale_incontextgauss_ISR_A517543999 gale_incontextgauss_IOV_A517543999 gale_healthsolutions_A517543999 pubmed_primary_29206838 crossref_primary_10_1371_journal_pone_0188231 crossref_citationtrail_10_1371_journal_pone_0188231 |
| ProviderPackageCode | CITATION AAYXX |
| PublicationCentury | 2000 |
| PublicationDate | 2017-12-05 |
| PublicationDateYYYYMMDD | 2017-12-05 |
| PublicationDate_xml | – month: 12 year: 2017 text: 2017-12-05 day: 05 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States – name: San Francisco – name: San Francisco, CA USA |
| PublicationTitle | PloS one |
| PublicationTitleAlternate | PLoS One |
| PublicationYear | 2017 |
| Publisher | Public Library of Science Public Library of Science (PLoS) |
| Publisher_xml | – name: Public Library of Science – name: Public Library of Science (PLoS) |
| References | ref13 D Leys (ref3) 2007; 38 D Strbian (ref9) 2015; 46 R Flin (ref10) 2015; 29 DM Gaba (ref15) 2000; 320 R McCarney (ref19) 2007; 7 W Hacke (ref4) 2008; 359 D Tahtali (ref12) 2017 ref17 ref16 M Goyal (ref5) 2016; 387 M Köhrmann (ref7) 2011; 6 LH Schwamm (ref8) 2013; 6 J Emberson (ref1) 2014; 384 A Meretoja (ref6) 2012; 79 JL Saver (ref18) 2009; 40 C Foerch (ref14) 2008; 105 D Tahtali (ref11) 2016; 87 M Goyal (ref2) 2016; 279 |
| References_xml | – volume: 279 start-page: 888 year: 2016 ident: ref2 article-title: Analysis of Workflow and Time to Treatment and the Effects on Outcome in Endovascular Treatment of Acute Ischemic Stroke: Results from the SWIFT PRIME Randomized Controlled Trial publication-title: Radiology doi: 10.1148/radiol.2016160204 – volume: 38 start-page: 2985 year: 2007 ident: ref3 article-title: Facilities available in European hospitals treating stroke patients publication-title: Stroke doi: 10.1161/STROKEAHA.107.487967 – ident: ref13 – volume: 320 start-page: 785 year: 2000 ident: ref15 article-title: Anaesthesiology as a model for patient safety in health care publication-title: BMJ doi: 10.1136/bmj.320.7237.785 – volume: 6 start-page: 493 year: 2011 ident: ref7 article-title: Avoiding in hospital delays and eliminating the three-hour effect in thrombolysis for stroke publication-title: Int J Stroke doi: 10.1111/j.1747-4949.2011.00585.x – volume: 40 start-page: 2433 year: 2009 ident: ref18 article-title: Number needed to treat to benefit and to harm for intravenous tissue plasminogen activator therapy in the 3- to 4.5-hour window: joint outcome table analysis of the ECASS 3 trial publication-title: Stroke doi: 10.1161/STROKEAHA.108.543561 – volume: 29 start-page: 27 year: 2015 ident: ref10 article-title: Basic concepts for crew resource management and non-technical skills publication-title: Best Pract Res Clin Anaesthesiol doi: 10.1016/j.bpa.2015.02.002 – volume: 359 start-page: 1317 year: 2008 ident: ref4 article-title: Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke publication-title: N Engl J Med doi: 10.1056/NEJMoa0804656 – year: 2017 ident: ref12 article-title: Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department—A Practical Guide publication-title: J Vis Exp – volume: 6 start-page: 543 year: 2013 ident: ref8 article-title: Temporal trends in patient characteristics and treatment with intravenous thrombolysis among acute ischemic stroke patients at Get With The Guidelines-Stroke hospitals publication-title: Circ Cardiovasc Qual Outcomes doi: 10.1161/CIRCOUTCOMES.111.000095 – volume: 46 start-page: 1275 year: 2015 ident: ref9 article-title: Trends in Door-to-Thrombolysis Time in the Safe Implementation of Stroke Thrombolysis Registry: Effect of Center Volume and Duration of Registry Membership publication-title: Stroke doi: 10.1161/STROKEAHA.114.007170 – volume: 7 start-page: 30 year: 2007 ident: ref19 article-title: The Hawthorne Effect: a randomised, controlled trial publication-title: BMC Med Res Methodol doi: 10.1186/1471-2288-7-30 – volume: 384 start-page: 1929 year: 2014 ident: ref1 article-title: Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials publication-title: Lancet doi: 10.1016/S0140-6736(14)60584-5 – volume: 79 start-page: 306 year: 2012 ident: ref6 article-title: Reducing in-hospital delay to 20 minutes in stroke thrombolysis publication-title: Neurology doi: 10.1212/WNL.0b013e31825d6011 – volume: 105 start-page: 467 year: 2008 ident: ref14 article-title: The projected burden of stroke in the German federal state of Hesse up to the year 2050 publication-title: Dtsch Arztebl Int – volume: 387 start-page: 1723 year: 2016 ident: ref5 article-title: HERMES collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials publication-title: Lancet doi: 10.1016/S0140-6736(16)00163-X – volume: 87 start-page: 1322 year: 2016 ident: ref11 article-title: Crew resource management and simulator training in acute stroke therapy publication-title: Nervenarzt doi: 10.1007/s00115-016-0162-5 – ident: ref16 – ident: ref17 |
| SSID | ssj0053866 |
| Score | 2.364383 |
| Snippet | To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in the... Background To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in... Background To meet the requirements imposed by the time-dependency of acute stroke therapies, it is necessary 1) to initiate structural and cultural changes in... |
| SourceID | plos doaj unpaywall pubmedcentral proquest gale pubmed crossref |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database Enrichment Source |
| StartPage | e0188231 |
| SubjectTerms | Algorithms Biology and Life Sciences Care and treatment Computer and Information Sciences Computer simulation Decision making Emergency medical care Hospitals Interdisciplinary aspects Intervention Medical personnel Medicine and Health Sciences Neurology Patients People and Places Practice Research and Analysis Methods Science Policy Simulation Stroke Teams Thrombolysis Training Trends Workflow |
| SummonAdditionalLinks | – databaseName: DOAJ Directory of Open Access Journals dbid: DOA link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1Lb9QwELbQXuCCKK8GChiEBBzSJvEj8XFBVIUDSEBRb5HjOO2KXWfV7KriP_CjmYmdqBGV2gO33fU4kueVmfXMN4S85iarEqZNzGpRQIKiZVwxI2MmZZVnmda5L5D9Io-O-ecTcXJp1BfWhHl4YM-4g0ZUSZXK2iTW8EY1OjVJ0XBb14oLLQx636RQQzLlfTBYsZShUY7l6UGQy_66dXY_SQu8-5q8iHq8_tErz9bLtrsq5Py3cvL21q317wu9XF56LR3eI3dDPEnn_hw75JZ198lOsNiOvg2w0u8ekD89EPAq9Bo52ja025y3vywFOa86ql1Nu8UqjPOiw-wI2p1hPS54Y7r2TQW0n0dPF45qinMdMJYfHuV8VXk8Hz9dLGqLO4eWTtrPCXlIjg8__vhwFIdZDLGRKtvENTOFVLpKWZVIg2Yvq1oxEIwCYWvIonJRNxDv2AL_VrKFtPC9zrJEFSnjCXtEZg64v0toCk-U0uZKcw7ZJYQMGsKKqkmEgW2CR4QNgilNACrHMy_L_vYth4TF87ZEcZZBnBGJx11rD9RxDf17lPlIizDb_Q-gfGVQvvI65YvIC9SY0vesjs6inAuIyjDTUxF51VMg1IbDWp5Tve268tPXnzcg-v5tQvQmEDUtsMPo0D8BZ0IIrwnl3oQSHIaZLO-ifg9c6cpU5Xh7nXIBOwedv3r55biMD8X6PGfbrafhIs9T4OtjbyIjZ3EemixYEZF8YjwT1k9X3OKsRzoXkM1DxhuR_dHMbiTcJ_9DuE_JnQxjOKxdEntktjnf2mcQgW6q572z-QuAl4lU priority: 102 providerName: Directory of Open Access Journals – databaseName: ProQuest Central dbid: BENPR link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV3NbtQwELbK9gAXRPlroIBBSMAh2ySOneSA0Ba1KhwWVCjqLXJsp12xm4TNripuPAEnnpAnYSZxAhEV9LZZjy15xjOZiWe-IeRpqILMY1K5TPMYAhQp3Iwp4TIhsigIpIzaBNmpODwO357wkw0y7WphMK2ys4mNodalwm_ku34S4RWbH_JX1RcXu0bh7WrXQkPa1gr6ZQMxdoVsBoiMNSKbe_vT90edbQbtFsIW0LHI37XyGldlYcaeH-Od2OAF1eD499Z6VM3L-iJX9O-MyqvropJfz-V8_sfr6uAGuW79TDppD8YW2TDFTbJlNbmmzy3c9Itb5HsDELywNUgFLXNar5blZ0NB_ouaykLTerawbb5o11OC1meYpwtWmlZtsQFt-tTTWUElxX4P6ON3SxVttvnPbz8m3W_3fKYNzu2KPWnTQeQ2OT7Y__j60LVdGlwlkmDlaqZikcjMZ5knFBoEkemE-UIncAwkxFcR1zl4QibGD04mFgaedRB4Seyz0GN3yKgA_m8T6sOKQpgokWEIcSc4ExIcjiz3uIJpPHQI60STKgthjruep829XAShTMvdFAWaWoE6xO1nVS2Ex3_o91DqPS0CcDd_lMvT1OpzmvPMy2CPyjMqzJNc-sqL89BonYRccuWQR3hm0raatTcj6YSDv4YxYOKQJw0FgnAUmOVzKtd1nb559-kSRB-OBkTPLFFeAjuUtJUVsCcE9xpQ7gwowZSowfA2nvCOK3X6W-lgZnfqLx5-3A_jopi5V5hy3dKEPIp84OvdVkl6zmKnNBGz2CHRQH0GrB-OFLOzBgOdQ5wPsbBDxr2iXUq49_69j_vkWoB-G-Yr8R0yWi3X5gF4navsoTUlvwAW84cs priority: 102 providerName: ProQuest – databaseName: Unpaywall dbid: UNPAY link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtR3LbtQw0CrbA1yA8upCAYMQj0PSOI6d5LggqsKhIGBROaDIcRK66m6yarKq4ID4Ak58IV_CTOxEBIooB27Z9YwVj8fjmcyLkHuB9lOPK-3wTERgoCjppFxLh0uZhr6vVGgCZPfk7jR4vi_218j7LhfGUhBsxHlVt558fKjKfNtSchvrFRnvqct4yDoMdwlArsci9GvdbysO4ZexBhOQzpB1KUBVH5H16d7LyTvjafYd6XvcptP9aabBddVW9e9l9wjf7CTF9Pf4yrOrcqk-Hqv5_KfLa-cC-dwt28SsHLqrJnX1p18qQv43ulwk563aSydmlg2ylpeXyIYVLDV9aKtfP7pMvrb1ihc2JaqkVUHr5qg6zCmw46KmqsxoPVvYrmO0a3FB6wMMG4ZLgy5N7gNtMLuFzkqqKLafQJOjm6o0we_fv3ybdM_O8SzLEbfLPaVtQ5MrZLrz9M2TXcc2jXC0jP3GybiOZKxSxlNPapRPMs1izmQWA1cqMPdCkRWgmOURfv_KI5nD78z3vThiPPD4VTIqgWSbhDKYUco8jFUQgBkMuo0C_SctPKEBTQRjwjveSLStqI6rnietmzAEy8pQN8E9SOwejInTYy1NRZG_wD9GtuthsR54-wcwQWI3PylE6qWwRu3lOijiQjHtRUWQZ1kcCCX0mNxGpk1Mcm0v1ZKJAPURTdJ4TO62EFgTpMSgow9qVdfJsxdvTwH0-tUA6IEFKiogh1Y20QPWhDw6gNwaQIJk04PhTWTyjip1wuIQ3ewsEIDZHbuTh-_0wzgpBhKWebUyMIEIQwZ0vWZOaU9ZbNwmIx6NSTg4vwPSD0fK2UFbkl2EDCRMOCZuf9JPtbnX_xXhBjnno2KJAVVii4yao1V-E9TiJr1lhdsPeJ3AYw priority: 102 providerName: Unpaywall |
| Title | Implementation of stroke teams and simulation training shortened process times in a regional stroke network—A network-wide prospective trial |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/29206838 https://www.proquest.com/docview/1973027145 https://www.proquest.com/docview/1973457711 https://pubmed.ncbi.nlm.nih.gov/PMC5716597 https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0188231&type=printable https://doaj.org/article/f5b0b16dc0ec4f9fa1c08f4edd945a5c http://dx.doi.org/10.1371/journal.pone.0188231 |
| UnpaywallVersion | publishedVersion |
| Volume | 12 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVFSB databaseName: Free Full-Text Journals in Chemistry (Open Access) customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: HH5 dateStart: 20060101 isFulltext: true titleUrlDefault: http://abc-chemistry.org/ providerName: ABC ChemistRy – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: KQ8 dateStart: 20060101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: KQ8 dateStart: 20061001 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: DOA dateStart: 20060101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVEBS databaseName: EBSCOhost Academic Search Ultimate customDbUrl: https://search.ebscohost.com/login.aspx?authtype=ip,shib&custid=s3936755&profile=ehost&defaultdb=asn eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: ABDBF dateStart: 20080101 isFulltext: true titleUrlDefault: https://search.ebscohost.com/direct.asp?db=asn providerName: EBSCOhost – providerCode: PRVEBS databaseName: EBSCOhost Food Science Source customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: A8Z dateStart: 20080101 isFulltext: true titleUrlDefault: https://search.ebscohost.com/login.aspx?authtype=ip,uid&profile=ehost&defaultdb=fsr providerName: EBSCOhost – providerCode: PRVBFR databaseName: Free Medical Journals customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: DIK dateStart: 20060101 isFulltext: true titleUrlDefault: http://www.freemedicaljournals.com providerName: Flying Publisher – providerCode: PRVFQY databaseName: GFMER Free Medical Journals customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: GX1 dateStart: 20060101 isFulltext: true titleUrlDefault: http://www.gfmer.ch/Medical_journals/Free_medical.php providerName: Geneva Foundation for Medical Education and Research – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: M~E dateStart: 20060101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre – providerCode: PRVAQN databaseName: PubMed Central (Open Access) customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: RPM dateStart: 20060101 isFulltext: true titleUrlDefault: https://www.ncbi.nlm.nih.gov/pmc/ providerName: National Library of Medicine – providerCode: PRVPQU databaseName: Health & Medical Collection (Proquest) customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: 7X7 dateStart: 20061201 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: http://www.proquest.com/pqcentral?accountid=15518 eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: BENPR dateStart: 20061201 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Technology Collection customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: 8FG dateStart: 20061201 isFulltext: true titleUrlDefault: https://search.proquest.com/technologycollection1 providerName: ProQuest – providerCode: PRVPQU databaseName: Public Health Database (Proquest) customDbUrl: eissn: 1932-6203 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: 8C1 dateStart: 20061201 isFulltext: true titleUrlDefault: https://search.proquest.com/publichealth providerName: ProQuest – providerCode: PRVFZP databaseName: Scholars Portal Journals: Open Access customDbUrl: eissn: 1932-6203 dateEnd: 20250930 omitProxy: true ssIdentifier: ssj0053866 issn: 1932-6203 databaseCode: M48 dateStart: 20061201 isFulltext: true titleUrlDefault: http://journals.scholarsportal.info providerName: Scholars Portal |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjR3LbtNAcNWmB7ggyquBEhaEBBwc-bEP-4BQWjUUJEJVCGpP1npttxGJHeJEpTe-gBNfyJcwY68tLFLRi5V4Z1bamZ3ZGe88CHnOtBvZntKWF3MfHBQlrMjTwvKEiKTrKiWrANmROByz9yf8ZIPUPVsNAYu1rh32kxovpv3v3y7fgMC_Lrs2SKdG6s_zLOnbjo83W5tkC86qAJs5fGDNvQJItxAmge4qzNYBVdbxb7R1Zz7Ni3Wm6L8RlTdW2VxdXqjp9K_janib3DJ2Jh1UG2ObbCTZHbJtJLmgL0256Vd3yc-yQPDM5CBlNE9psVzkXxMK_J8VVGUxLSYz0-aL1j0laHGOcbqgpem8SjagZZ96OsmootjvAW38eqqsijb__ePXoP5tXUziBHHrZE9adhC5R8bDg8_7h5bp0mBpEbhLK_a0LwIVOV5kC40KQURx4DkiDmAbKPCvJI9TsIQSHz84Jb5I4H_sunbgOx6zvfukkwH9dwh1YEYhEhkoxoB5YEwoYGKU2lwDGmdd4tWsCbUpYY6rnoblvZwEV6aibogMDQ1Du8RqsOZVCY__wO8h1xtYLMBdvsgXZ6GR5zDlkR3BGrWdaJYGqXK07acsieOAccV1lzzBPRNW2ayNGgkHHOw19AGDLnlWQmARjgyjfM7UqijCdx-_XAPo03EL6IUBSnMgh1YmswLWhMW9WpC7LUhQJbo1vIM7vKZKETqBxHtth3HArHf9-uGnzTBOipF7WZKvKhjGpXSArg8qIWkoi53ShO_5XSJb4tMifXskm5yXNdA5-PngC3dJvxG0azH34dVLfERuumizYawS3yWd5WKVPAaLcxn1yKY8kfD09x18Dt_2yNbewejouFd-w-mVSgbejUdHg9M_bzWLiA |
| linkProvider | Scholars Portal |
| linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtR3LbtNAcFXCoVwQ5dVAoQsCAQentte7tg8IhUeV0lIkaKvczHq9biMSO8SJot74Ak58Bx_FlzBjrw0WFfTSm-OdXWXntTPeeRDyyFNubDOpLJbwABwUKayYKWExIWLfdaX0qwDZfTE49N4O-XCF_KhzYTCsstaJpaJOcoXfyLec0McrNsfjL6ZfLOwahberdQuNii129ekSXLbi-c5roO9j191-c_BqYJmuApYSoTu3EqYCEcrYYbEtFDKwiJOQOSIJ4W9L8Ad8nqRwcusAP5DoQGj4nbiuHQYO82wG614ilz0GugTkxx82Dh7oDiFMeh7znS3DDb1pnume7QR449Y6_souAc1Z0JmO8-IsQ_fveM3VRTaVp0s5Hv9xGG5fI1eNFUv7FdutkRWdXSdrRk8U9KkpZv3sBvlWlh-emAynjOYpLeaz_LOmwF2TgsosocVoYpqI0bpjBS1OMAoYzgA6rVIZ6ByTVegoo5JiNwn0IOqlsiqW_efX7_362VqOEo1z61RSWvYnuUkOL4Rat0gnA_yvE-rAikJoP5SeB14tmCoSzJk4tbmCadzrElaTJlKmQDruehyVt34-OEoVdiMkaGQI2iVWM2taFQj5D_xLpHoDi-W9yxf57Dgy2iJKeWzHsEdla-WlYSodZQepp5Mk9Ljkqks2kWeiKle2UVJRn4M1iB5m2CUPSwgs8ZFhDNGxXBRFtPP-6BxAHz-0gJ4YoDQHdChp8jZgT1g6rAW50YIERaVaw-vI4TVWiui3SMPMmuvPHn7QDOOiGBeY6XxRwXjc9x3A6-1KSBrMYh82EbCgS_yW-LRQ3x7JRidlhXXuOwI87S7pNYJ2LuLe-fc-Nsnq4ODdXrS3s797l1xx0ULEyCi-QTrz2ULfA_t2Ht8vlQolny5ai_0Ca0C7xQ |
| linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtR3LbtQw0CpFAi6I8upCoQaBgEO2SRzbyQGhhbJqKSoIKNpbcBynXbFNlmZXq974Ak58DZ_DlzCTOIGICnrpLYnHlubh8Uw8D0IeBNpPXKa0w1IegoOihJMwLRwmRCJ9XylZB8juiq294NWIj5bIjyYXBsMqG51YKeq00PiPfMOLJF6xeQHfyGxYxNvN4bPpFwc7SOFNa9NOoxaRHXO8APetfLq9Cbx-6PvDlx9ebDm2w4CjReTPnJTpUEQq8VjiCo3CLJI0Yp5II0BBgW8geZrBKW5C_FliQmHgPfV9Nwo9FrgM1j1HzkvGIgwnlKPW2QM9IoRN1WPS27CS0Z8Wuem7Xoi3b52jsOoY0J4Ly9NJUZ5k9P4du3lxnk_V8UJNJn8cjMMr5LK1aOmgFsEVsmTyq2TF6oySPraFrZ9cI9-qUsSHNtspp0VGy9lR8dlQkLTDkqo8peX40DYUo033CloeYEQwnAd0Wqc10BkmrtBxThXFzhLoTTRL5XVc-8-v3wfNs7MYpwbnNmmltOpVcp3snQm3bpDlHOi_SqgHKwphZKSCADxcMFsUmDZJ5nIN03jQI6xhTaxtsXTEehJXN4ASnKaaujEyNLYM7RGnnTWti4X8B_45cr2FxVLf1YfiaD-2miPOeOImgKN2jQ6yKFOedsMsMGkaBVxx3SPrKDNxnTfbKqx4wMEyRG8z6pH7FQSW-8hx4-yreVnG228-ngLo_bsO0CMLlBVADq1sDgfghGXEOpBrHUhQWrozvIoS3lCljH9vb5jZSP3Jw_faYVwUYwRzU8xrmIBL6QFdb9abpKUs9mQTIQt7RHa2T4f03ZF8fFBVW-fSE-B190i_3WinYu6tf-OxTi6A_opfb-_u3CaXfDQWMUiKr5Hl2dHc3AFTd5bcrXQKJZ_OWon9AmoLwAg |
| linkToUnpaywall | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtR3LbtQw0CrbA1yA8upCAYMQj0PSOI6d5LggqsKhIGBROaDIcRK66m6yarKq4ID4Ak58IV_CTOxEBIooB27Z9YwVj8fjmcyLkHuB9lOPK-3wTERgoCjppFxLh0uZhr6vVGgCZPfk7jR4vi_218j7LhfGUhBsxHlVt558fKjKfNtSchvrFRnvqct4yDoMdwlArsci9GvdbysO4ZexBhOQzpB1KUBVH5H16d7LyTvjafYd6XvcptP9aabBddVW9e9l9wjf7CTF9Pf4yrOrcqk-Hqv5_KfLa-cC-dwt28SsHLqrJnX1p18qQv43ulwk563aSydmlg2ylpeXyIYVLDV9aKtfP7pMvrb1ihc2JaqkVUHr5qg6zCmw46KmqsxoPVvYrmO0a3FB6wMMG4ZLgy5N7gNtMLuFzkqqKLafQJOjm6o0we_fv3ybdM_O8SzLEbfLPaVtQ5MrZLrz9M2TXcc2jXC0jP3GybiOZKxSxlNPapRPMs1izmQWA1cqMPdCkRWgmOURfv_KI5nD78z3vThiPPD4VTIqgWSbhDKYUco8jFUQgBkMuo0C_SctPKEBTQRjwjveSLStqI6rnietmzAEy8pQN8E9SOwejInTYy1NRZG_wD9GtuthsR54-wcwQWI3PylE6qWwRu3lOijiQjHtRUWQZ1kcCCX0mNxGpk1Mcm0v1ZKJAPURTdJ4TO62EFgTpMSgow9qVdfJsxdvTwH0-tUA6IEFKiogh1Y20QPWhDw6gNwaQIJk04PhTWTyjip1wuIQ3ewsEIDZHbuTh-_0wzgpBhKWebUyMIEIQwZ0vWZOaU9ZbNwmIx6NSTg4vwPSD0fK2UFbkl2EDCRMOCZuf9JPtbnX_xXhBjnno2KJAVVii4yao1V-E9TiJr1lhdsPeJ3AYw |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Implementation+of+stroke+teams+and+simulation+training+shortened+process+times+in+a+regional+stroke+network%E2%80%94A+network-wide+prospective+trial&rft.jtitle=PloS+one&rft.au=Tahtali%2C+Damla&rft.au=Bohmann%2C+Ferdinand&rft.au=Kurka%2C+Natalia&rft.au=Rostek%2C+Peter&rft.date=2017-12-05&rft.pub=Public+Library+of+Science&rft.eissn=1932-6203&rft.volume=12&rft.issue=12&rft_id=info:doi/10.1371%2Fjournal.pone.0188231&rft.externalDocID=1973027145 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1932-6203&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1932-6203&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1932-6203&client=summon |