关键词: 丰田生产方式; 急性缺血性卒中; 静脉溶栓; 入院至溶栓时间

Abstract:

Objective To investigate using Toyota Production System (TPS) to shorten patients’ door-toneedle time (DNT) and increase the proportion of patients with DNT≤60 minutes. Methods The patients with acute ischemic stroke who underwent recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis from June 2012 to December 2013 were taken as the control group, and the patients who were admitted from January 2014 to June 2015 via TPS formula were taken as the study group. The DNT time and the proportion of patients with DNT≤60 minutes were compared. Results The study included 68 patients in the control group and 87 patients in the study group. There was a significant statistical difference on the average DNT between the control group and the study group (P =0.002), and the average DNT in the control group and the study group were (92.27±16.98) minutes and (63.52±11.86) minutes respectively. The proportion of patients with DNT≤60 minutes was significantly increased from 6.11% to 51.09% (P =0.001). Conclusion Multi-discipline TPS team was helpful for optimizing process of administering thrombolytic therapy on acute ischemic stroke, reducing the delay time of rt-PA intravenous thrombolysis in the hospital, shortening DNT, and increasing the proportion of patients with DNT ≤ 60 minutes.

Key words: Toyota production system; Acute ischemic stroke; Intravenous thrombolysis; Door to needle time