Description of the emerging healthcare technology
A mobile stroke unit can be described as the ambulance that mainly provides services helping in diagnosing, evaluating as well as treating the symptoms of the acute stroke. This ambulance is very much different from the standard ambulances that carry people from homes or other places to the hospitals in time of emergencies. The mobile stroke unit mainly resembles an ambulance on the outside, but inside it is primarily seen to contain highly specialized staffs (Fassbender et al., 2017). It also includes types of equipment and medications that are strictly used for the diagnosis and treatment of the strokes. Such ambulances are seen to be equipped with the portable CT scanner. This equipment is capable of imaging the brain of the patient. This aspect helps in the detection of the type of the stroke that the patients are experiencing. The new technology in the healthcare system has the capability of transmitting the city scans wirelessly to the primary stroke unit in the healthcare centers that are immediately accessed by the neuroradiologists who are present in the stroke departments of the healthcare sectors (Walter et al., 2018). Here, the professional experts are seen to decipher if the patient is experiencing a stroke. If the patient is seen to experience stroke, the experts help in understanding whether the patients are suffering from the ischemic stroke caused by blood clots or suffering from the hemorrhagic stroke caused by the rupture of the blood vessel. In the time between, the neurologists are also seen to access the symptoms of the patients via the technologies like telemedicine technology while the en route to the hospitals (Holodinsky et al., 2018). Studies have shown that a mobile lab also remains closely associated with the technology. This mobile lab is also able to test different samples on the board. If the lab finds that the individuals are experiencing an ischemic stroke which is mainly the most common form of stroke experienced by the 87% of all the strokes, the onboard medical team can thereby initiate intravenous (IV) tissue plasminogen activator (tPA). This aspect would help in the attempt in breaking up the clot (Schuaib, 2018).
Time is a very crucial factor in the management of stroke symptoms of the patient and saving the life of the patient. Researchers call the first three hours after the onset of the stroke as the golden hour. It is essential for stroke affected patient to initiate the treatment within these primary three outcomes to prevent the patient suffer from long-term disabilities and to save the life of the person from threatening situations (Bowry et al., 2015). Studies have shown that 52% of the individuals suffering from an ischemic stroke caused by huge clots had better long-term outcomes if they had received the IV administration of the tissue plasminogen activator (IV tPA) medication with the first 60 minutes of the symptom onsets. This data compares to that of only 27% of the patients showing good long-term outcomes concerning disability and living independently when the medication is administered beyond the 3 hours of the golden hours. Another study conducted by (Yamal et al., 2018) had given similar opinions. The research has shown that acute ischemic stroke mainly results from embolic or thrombotic occlusion of the intracranial artery. This administration of the I.V. fibrinolysis with recombinant tissue plasminogen activator (rt-PA) within the first three to four hours of the onset of the stroke symptoms helps in reducing the degrees of the disability from acute ischemic strokes. From these studies, it is seen that it becomes essential for the caregivers and the family members to reach the healthcare centers with the patients within this golden hours (Shownkeen et al., 2018). However, many cases had been reported where families and caregivers become so nervous and anxious seeing their patients go through these symptoms; they cannot identify the emergency and often becomes late in admitting the patients to the emergency wards. Therefore, disability chances increase in such patients along with increased sufferings with long-term poor quality outcomes. Studies say that loss of every minute after the onset of the stroke can destroy 2 million cells every per minute they do not receive medical treatment during the stroke. Therefore, getting early treatment is very necessary.
Analysis of the reasons why healthcare needs this technology
Moreover attending to patients in the early hours also helps the healthcare professionals to handle the cases much more effectively as the degree of emergency interventions reduces and becomes more comfortable for them to manage (Kunz et al., 2016). Moreover, the healthcare professionals can save more resources and days required for rehabilitation. Healthcare fundings and costs needed for handling critical cases of strokes that deteriorated due to delay in treatment also reduces. Hence, mobile stroke units would be beneficial in such a situation. These would save time and provide immediate treatment to patients thereby saving the life of the patient and ensuring positive long-term benefits and prevention of deterioration of the ischemic penumbra.
One of the most critical actions that need to be taken for implementation of such technologies is to develop a detailed report which would contain the statistics of the death rates and severe deterioration of patient health who have suffered from the stroke and had not been transferred to the hospital within the 3 hours called the golden hours. This social analysis conducted would contain the number of the patients who have suffered death or poor long-term health outcomes along with high expenditure of the extended long-term care that professionals need to provide to such patients (Bowry et al., 2018). Accordingly, the reports would be discussed in the board meetings making the decision makers understand the complexity of the situation and the urgency of the implementation of the technology. Once, the green signals are achieved from the healthcare organizations; the second step would initiate.
The next step would be advocating of the issues to the funding organisations and the government as well making them visualize the need for the implementation of the technology. Close coordination and collaboration with the finance department and the health engineering department to develop an estimate of the funding that would be required for the implementation of the program (Sheiki et al., 2018). The cost of the operating of the mobile stroke unit would be including the initial investment in the vehicles as well as the types of equipment. Planning of the distribution of the funds would also be done on the ongoing operations, maintenance as well as the staffing costs that would associate with the implementation of the mobile stroke units. Once the funding plan is accepted and the concerned authorities ensure funding, the third step should be initiated.
The third step would mainly comprise of the change management plan which indeed is one of the most important concerns that every new health technology initiation faces. The present staffs in the emergency and stroke units are comfortable in working with the current system. This aspect is because the skills and knowledge gained by them through the experiences they have learned in working in the order make them perform their tasks safely ensuring patient safety and acre quality (Sheiki et al., 2018). Researchers suggest any new changes might create anxiety, stress, tensions and inquisitiveness among the present staffs regarding the necessity and the complexity of the new system. They might feel insecure about their job and might feel unskilled to meet the new requirements for handling the technology successfully. In such situations, managers and leaders need to undertake transformational leadership style and proper change management theories. The rationale for the change needs to be discussed followed by the explanation of the urgency of the situation. Accordingly, their concerns need to be handled, and proper training sessions need to be provided. All these aspects would help in the effective implementation of the program.
Implementation procedures
Many risks are associated with the health of the patients if the mobile stroke units are not implemented within the healthcare units. Without the allocation of this technology in the stroke management for patients, early recognition and attaining to the treatments cannot be done and time would be wasted during the golden hours. This would impose risks on the life of the patient and would increase the level of disabilities and negative long-term outputs along with increased sufferings (Crumlet et al., 2018). Risks of poor health outcomes will increase as earlier recognition, more accurate triage, improvement in the management of the blood pressure and other critical variables cannot be done within the golden hours. These aspects would further increase the risks of spreading of the death of neurons from the ischemic penumbra to that of the surrounding regions. Level of paralysis, speech issues, disabilities and others would increase with this failure increasing the risks of poor quality lives.
In the case of the healthcare services, the absence of the technology would bring out adverse outcomes increasing various kinds of risks to the healthcare areas as well. Researchers are of the opinion that mobile stroke units have shown improved outcomes owing to the earlier treatment as it helps in the reduction of healthcare costs and saving of healthcare researches to a large extent. The studies have shown that it results in the reduction in the costs of the long-term of stroke care and rehabilitation (Donnan et al., 2018). Therefore, not having such technology will increase the risk of resource and funding shortage in the healthcare organizations. It also helps in the increase of the quality-adjusted life years, and hence word of mouth promotion might cause the patients and family members to opt for other hospitals who have this facility. Therefore, not having this facility will impact the brand and reputation of the hospital increasing the risk of lesser footfall.
One of the health risks is identified which might impact the healthcare professionals who are present in the mobile stroke units. Mobile stroke units are seen to carry a CT scanner, and therefore, healthcare providers might get exposed to the radiation. They would not have encountered such radiation if they had to work in the pre-hospital care settings. Therefore, effective health and safety management needs to be taken so that this technology reduces the risk of professionals working in the mobile stroke uni (Warach et al., 2015). Moreover, the professionals might have to work within the moving unit system that is a restricted space within the vehicle. This aspect would restrict the movement and limit the professionals forcing them to stay within the small area working for hours. This might create physical and mental stress on the professionals. Such risks should be mitigated when the technology would be implemented.
This is a new form of technology and it is essential to discuss the plan in details with every critical stakeholder. The board members should be communicated about the expenditures that are associated with the new technology. This discussion would contain funding allocation for the vehicles, equipment, staff allocation, advertising and many others. the discussion would also be done with the planning procedure of the implementation procedures, seeking permission from the government, advocating of the issues to the government so that adequate finds can be collected before initiation of the projects. Moreover, the evaluation committee should be developed who would monitor the work procedures of the stroke department and accordingly advice necessary changes required (Grunwald et al., 2016). The board members should also be requested to allocate funds for the training procedures for the staff members so that they can align with the new change management.
The healthcare professionals would be comfortable with the traditional system of working in the emergency unit and stroke departments. They might not want to take up new technologies. Researchers suggest that any further changes might create negativities around the working teams. Therefore, it is essential to discuss the main reasons for implementing the technology with the healthcare members. This would help them in understanding the urgency of the situation and such communication reduces the chance of conflicts and negative feelings between medical staffs and the organization. Accordingly, each of their concerns should be handled with patience and positivity with constructive feedback making them feels that the organization is trying its best to help them. This feeling will help them to develop positive attitudes and align with the new set of goals (Sheiki et al., 2018). Adopting a transformational leadership and ensuring effective change management would help in implementing this technology without creating any issues. The organizations need to promote this new introduction of strategies through media like television, social networking sites, radios and even advertisements on roads and others. These would help the citizens to understand the importance of this technology. This would help them to learn the steps they need to take when their family members face stroke and would be able to contact the hospital as first as they could. Hence, this discussion would be critical.
Stroke is the third leading cause of the disorder in the nation of Australia. In the year 2015, there were about 10,869 stroke fatalities in the nation. Data shows that in the year 2017, estimates given by Stroke foundation Australia suggested that within the year 2017, 475000 people would be there who would have lived with effects of stroke. This was again predicted to have increased to one million by the time 2050. About 30% of the stroke survivors were found to be of the working age. This means if they are affected, their productivity would have been hampered and this would affect the economic condition of the nation (Ebinger et al., 2014). About 65% of the stroke survivors suffer a disability that impedes their ability for carrying out the different daily activities unassisted. The Financial cost of stroke in the nation is estimated to be about 5 billion each year. Hence, implementation of the mobile stroke units would be able to save and attend people within the golden hours of the treatment reducing the chances of mortality due to stroke and also reducing the levels of disabilities in the nation due to early intervention. Therefore, this technology would reduce long-term healthcare costs of strokes and would prevent creating pressure on the economic condition of the nation.
References:
Bowry, R., Nour, M., Kus, T., Parker, S., Stephenson, J., Saver, J., … & Ostermayer, D. (2018). Intraosseous Administration of Tissue Plasminogen Activator on a Mobile Stroke Unit. Prehospital Emergency Care, (just-accepted), 1-15.
Bowry, R., Parker, S. A., Yamal, J. M., Hwang, H., Appana, S., Rangel-Gutierrez, N., … & Grotta, J. C. (2018). Time to Decision and Treatment With tPA (Tissue-Type Plasminogen Activator) Using Telemedicine Versus an Onboard Neurologist on a Mobile Stroke Unit. Stroke, 49(6), 1528-1530.
Bowry, R., Parker, S., Rajan, S. S., Yamal, J. M., Wu, T. C., Richardson, L., … & Grotta, J. C. (2015). Benefits of stroke treatment using a mobile stroke unit compared with standard management: the BEST-MSU study run-in phase. Stroke, 46(12), 3370-3374.
Crumlett, H. S., Lindstrom, A., Mohajer-Esfahani, M., & Shownkeen, H. (2018). The Feasibility and Development of a Mobile Stroke Unit in a Community Setting. Stroke, 49(Suppl_1), A13-A13.
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Kunz, A., Ebinger, M., Geisler, F., Rozanski, M., Waldschmidt, C., Weber, J. E., … & Villringer, K. (2016). Functional outcomes of pre-hospital thrombolysis in a mobile stroke treatment unit compared with conventional care: an observational registry study. The Lancet Neurology, 15(10), 1035-1043.
Sheikhi, L. E., Mullaguri, N., Nocero, J., Reimer, A. P., Schrock, J., Rasmussen, P. A., … & Cleveland Pre-Hosp Acute Stroke Treatment (PHAST) Study Group. (2018). Abstract TP285: Improving Mobile Stroke Unit Intravenous Thrombolysis Times Through Parallel Processing. Stroke, 49(Suppl_1), ATP285-ATP285.
Shownkeen, H., Lindstrom, A., Graham, S., Iacob, T., Crumlett, H., & Mohajer-Esfahani, M. (2018). Abstract TP218: Mobile Stroke Unit Improves Time to Treatment in Suburban Community. Stroke, 49(Suppl_1), ATP218-ATP218.
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