Empowering Data-Driven Stroke Treatment

What it delivers

Understand your institution’s performance by using Process Analysis

INSTOR provides six sub-categories of process analysis reports. Please click the blue category names below to see examples.

 provides minimum/median/maximum times and raw data for key processes of care across the emergency stroke management continuum.

  • The overview provides all details concerning analysis of the many time intervals, clinical outcomes and other measures tracked by INSTOR.

Long-Term Trends demonstrate monthly institutional performance across various processes of care such as door to imaging, door to treatment (including Intravenous tissue Plasminogen Activator (IV tPA) therapy and Endovascular Therapy (EVT), and door to successful revascularization (TICI 2a, TICI 2b, TICI 3, etc.).

  • Monthly median times for processes of care surrounding the endovascular process are graphically displayed, including arrival to patient-on-the-table, arrival to puncture, puncture to start of EVT, etc. Each of these time components are also compared to an anonymous national aggregate.

  • Monthly median times for major processes of care are graphically plotted over a two-year period.  These trends are then compared to both the defined national benchmark (dotted line) and an anonymous national aggregate.

Current Trends of institutional performance across multiple processes of care from patient arrival to completion of emergency stroke treatment; each graph, reflecting an individual process measure, e.g door to CT, plots time intervals for your last 30 patients and utilizes a moving average of your most recent data to demonstrate current performance.  This instant feedback allows you to clearly assess your institution’s evolving performance to facilitate real-time improvement.

  • INSTOR facilitates an in-depth analysis of participating institutions’ pertinent processes of care for patients treated with EVT.  The dots displayed on the scatter plot are live; INSTOR can identify exactly which patient a particular dot might represent simply by clicking it.

  • INSTOR facilitates an in-depth analysis of participating institutions’ individual processes of care for individual patients.  The last 30 patients are represented on a scatter plot with a trend line.  To facilitate maximum clarity, each data point shows the actual time and date of the event when touched by the mouse.

Personnel Response Analysis keeps you apprised of how your stroke team response time may impact your institutional performance; each graph, reflecting an individual process measure, e.g. door to neurologist or door to neurointerventionist, plots time intervals for your last 30 patients but demonstrates performance as a moving average for your last six.  This instant feedback on individual or group personnel response times allows you to clearly assess static or evolving behavior to facilitate real-time improvement.

  • Response times for each member of the stroke response team are tracked in real-time.  Each dot represents an individual patient and the caregiver’s response time for that individual patient.  This overview provides evidence of where breakdowns occur during the stroke treatment process.

Patient Timeline Analysis provides a performance assessment of individual stroke cases represented by individual timelines of major processes of care for any group of patients treated by IV tPA or EVT, for any date range specified.  This instant visual feedback on institutional performance where it concerns every major process interval for an individual case facilitates the unique opportunity to assess the sequence of events, which can allow for immediate detection and correction of potential problems while the case is still fresh in your mind.

  • Every step in the care of individual patients is represented in a graphic timeline, color-coded for ease of viewing.  This graphic clearly highlights both expedient care as well as any delays that are in need of improvement.   The EVT timeline includes all major steps to the point of starting EVT.

  • For any particular patient, INSTOR makes it possible to retrieve a detailed summary of all data relevant to processes of care, instantly.

Variances are “discrepancies” or “differences” and in the case of emergency stroke care, “variances” represent situations where processes or steps did not occur as expected or desired.  INSTOR automatically analyzes every step in every case and identifies performance that does not meet goals and/or could possibly be improved or need further evaluation.  Each “variance” is presented in a timeline; with a click, the specific patient summary is retrieved instantly.

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All six categories of reports are presented in graphic format, enabling users to quickly and easily understand and assess results.  Likewise, this report-friendly information can easily be parlayed into professional PowerPoint or other presentations that can be disseminated on request to any audience.

Across all categories listed above, see a list of process performance measures that are not available through any other registry but INSTOR.