At a press conference today, the Minister of Health of the Government of Catalonia, Manel Balcells i Díaz, presented “One Step Stroke”, a pioneering technology and approach to improve stroke care that has been launched by Vall d’Hebron University Hospital.
In his speech, Balcells stressed that “this project is not only a new way of addressing the stroke protocol, but also saves time and gains time, and in strokes, acting quickly is key”. He also pointed out that “this project also represents a new way of contracting services, known as innovative public procurement, which promotes innovation” which “in this case will enable patients who have suffered a stroke to lead a normal life”.
One Step Stroke transforms the care of ischaemic and haemorrhagic stroke patients by concentrating the entire approach in a single, direct access room to reduce the time from when the patient arrives at the A&E to the moment they receive treatment. It is, therefore, a new technology accompanied by an innovative approach. After a year of structural and technological preparations, this project, the first of its kind the world, is now operational.
One Step Stroke has been accompanied by the refurbishment of the interventional neuroradiology area, which has been equipped with the most innovative technology so that the team of Neurology and Neuroradiology professionals can assess, diagnose and treat patients more quickly. The project has been carried out through a temporary consortium (UTE) formed by Medtronic and Siemens Healthineers.
One Step Stroke also incorporates the SmartStroke digital platform developed by Siemens Healthineers, which integrates the patient’s medical history with other data generated by the patient through medical devices and various digital applications during their journey through the healthcare system, both during admission and follow-up. It facilitates comprehensive process monitoring through advanced dashboards.
“Today we are officially inaugurating One Step Stroke, a project that is part of the transformation of the new Vall d’Hebron, a strategic commitment that involves creating new facilities and improving infrastructure with cutting-edge technology to address the challenges posed by healthcare,” said Dr Albert Salazar, manager of the Vall d’Hebron University Hospital.
Thanks to the One Step Stroke project, patients with stroke symptoms are directed straight to the One Step Stroke room instead of following the traditional A&E route. This involves using a corridor that has been exclusively designated for transferring these patients. “The pioneering technological solution in the One Step Stroke room combines a biplane angiograph for performing mechanical thrombectomy, the standard procedure for removing blood clots that cause a stroke, with equipment for performing a CT scan before, during, and after thrombectomy to assess the patient’s cerebral blood flow,” explained Dr Manel Escobar, clinical director of the Diagnostic Imaging Service at Vall d’Hebron University Hospital and the Vall d’Hebron Institute of Diagnostic Imaging.
Siemens Healthineers has developed both the ARTIS Icono Biplane, the equipment for performing thrombectomies, and SOMATOM Edge Plus sliding gantry, which allows CT scans to be performed on the patient without moving them during the procedure, as it moves along magnetic rails.
“By transferring the stroke patient directly to the angiography suite for immediate examination and treatment, we double the probability of a good functional prognosis for patients with more severe strokes: we estimate that 48% can achieve near full clinical recovery after undergoing direct thrombectomy, compared to 27% of patients who follow the traditional pathway,” said Dr Carlos Molina, head of the Neurology Service Section, head of the Stroke Unit and coordinator of the Vall d’Hebron Stroke Process.
Patients who present sudden neurological symptoms suggestive of a stroke and moderate or severe clinical symptoms are transferred directly to the One Step Stroke room either from the ambulance or from the A&E department. “The One Step Stroke room allows for diagnosis, clinical assessment, and stabilisation, as well as a significant number of treatments. This minimises intrahospital transfers, resulting in time savings for patient care,” added Dr Alejandro Tomasello, head of the Interventional Neuroradiology section at Vall d’Hebron University Hospital.
“The ultimate goal of One Step Stroke is to minimise the time it takes to treat stroke patients and this involves senior imaging technicians and nursing professionals working in an integrated way. On the part of technicians, preparing the specific material and angiograph technology for the treatment of these patients and, the nursing team setting up the material together with the neuroradiologist and providing haemodynamic support for the patient in collaboration with the anaesthesiologist,” emphasised Neus Salmeron, nurse in charge of angioradiology, and Cristina Losada, senior imaging diagnostics technician in charge of angioradiology material. Nursing staff are involved in the stabilisation process, control, medication administration, and instrumentation of the interventional procedure. The technicians are responsible for operating the sophisticated biplane and sliding CT equipment.
One Step Stroke also incorporates the SmartStroke platform, which systematically collects clinical data and carefully defined cross-cutting indicators to ensure the best functional prognosis with the highest efficiency and provide more predictive and personalised medicine. SmartStroke also enables direct communication with the patient once they are discharged, remote monitoring, teleconsultations, and precise control of vascular risk factors, allowing rehabilitation to be monitored from their home.
Medtronic provides this project with an integrated approach to care processes and procedures, taking into account the different phases of the patient care cycle, which is particularly relevant in time-dependent pathologies such as this one. An approach that will maximise efficiency in materials handling, while offering a supply model for personalised therapy for each patient. In addition, to measure the impact of these results, indicators such as PROMs (Patients Reported Outcome Measures) will be monitored, providing information about the patient’s physical and cognitive state and evolution.
The One Step Stroke project has a total cost of 18,185,676 euros, co-financed at 50% with European Regional Development Funds (FEDER), contributing 9,092,838 euros, to the 2014-2020 Operational Programme of Catalonia that promotes Innovative Public Procurement projects within the framework of SISCAT (Integrated Public Healthcare System of Catalonia, of which Vall d’Hebron is a part). Innovative Public Procurement encourages innovation from the public sector and obliges companies to meet a series of healthcare and health outcome-based indicators. This collaborative project between Vall d’Hebron, Siemens Healthineers and Medtronic will have an initial duration of five years.