At Péterfy Hospital in downtown Budapest, urgency is a matter of course. As well as a general hospital it is a trauma centre where the difference between life and death is often measured in seconds.
An environment geared for speed, it is a felicitous setting for treating stroke where the cost of a minute wasted is counted in 1,9 million neurons, 14 billion synapses and 12 kms of myelinated fibres through which human thoughts pass. Conversely, every minute saved between symptom onset and treatment to restore the flow of blood and oxygen to the brain can make the difference between a life-altering catastrophe and a life resumed.
Keenly aware of the difference a minute makes, the stroke team at Péterfy Hospital thrived in this high-paced environment where every piece of infrastructure supported their own efforts to eliminate delay, streamline decision making and ensure not a single patient fell outside the therapeutic window. A spirit of friendly competition among especially the younger stroke physicians further cut into door-to-needle times, delivering significant benefits for their patients.
But in May 2021, as the global healthcare sector was starting to emerge from the most serious health crisis in a century, the stroke team at Péterfy Hospital was facing a crisis of its own. Institutional restructuring would relocate the neurology department to a building a kilometre away, replacing their built-for-speed infrastructure with a relatively tranquil setting. Their challenge would be to provide a similar level of care in an environment far less primed for the prompt action and laser-sharp focus that save lives in an emergency.
Barely 18 months later, Péterfy Hospital is about to become only the third hospital in Hungary to earn an ESO Angels Diamond Award, given to hospitals that meet the most stringent criteria for excellence in stroke care.
Hard work aside, here are five reasons why the stroke team at Péterfy Hospital didn’t only meet the challenge, but overcame it to qualify for an international award.
1 They did it as a team
Stroke care is teamwork. The stronger a team, the better outcomes they deliver for their patients. When confronted with a challenge that could potentially impact all their future patients, the doctors at Péterfy Hospital rallied their team spirit and by looking for solutions together turned a crisis into a problem-solving challenge.
2 Leadership is shared
Lead by the chief of neurology Dr Pál Salacz who set the tone, everyone in the team took ownership of the challenge and shared their ideas for mitigating the impact of the move on patient care. This positive attitude spread to everyone they asked to help them adapt to the new situation – from their colleagues in radiology, the laboratory and ICU to their partners in the EMS.
3 They had good practices already in place
Before May 2021 prenotification was standard and the call from EMS was received by the neurologist on duty or the stroke unit. Plus, despite having an emergency department on the premises, to avoid triage delay and speed up decision making the neurologist met the patient at the door. There was no reason why they shouldn’t transfer these practices to their new building where there was the additional advantage of the patient being brought directly to CT.
4 They brought their sense of urgency with them
Emergency is not a department but a mindset, and the stroke team at Péterfy Hospital brought this mindset with them. No longer working in a system that was geared for speed, they knew that to get the same results they would have to work even harder. Their approach was to act as if the new building was an emergency hospital and to bring the urgency and attitudes they had developed in their previous building across to their new location. That it could take years for an emergency department to be installed at their new premises now hardly matters, for where stroke patients admitted to Péterfy Hospital are concerned, there may as well already be one.
5 Recognition is a reason to work harder
Being recognised for their work has brought the stroke team at Péterfy Hospital even closer together, says the young physician who leads their data collection effort. “Everybody was happy and excited when we heard of the possibility of winning the award, and as a result we are working even harder if that’s possible. At times we feel that our DTN time and recanalisation rate are not good enough, but this positive feedback clears the doubt and lets us focus on the work itself so we can improve even further.” Although they don’t need the spotlight bestowed by an award, they are above all happy that it won’t be one individual that is recognised but their entire team, for work they can all be proud of.
