Specialty
Neurology
Thrombolysis has a window measured in hours, and most Indian districts have no unit ready to deliver it. The patient who arrives inside the window then loses it inside the hospital, to a scan queue, a consent conversation and a drug that has to be found, while the times that would prove any of this are written on a sheet at the bedside.
The window closes while the paperwork opens.
Impact and action
The clock.
- Onset, arrival, scan and needle are four times written by four people, and the interval between them is worked out afterwards, if at all.The stroke pathway runs as a timed procedure that shows the team which step the case is on and what comes next.Cadence
- A step that runs late is noticed by whoever happens to be watching.A late step is flagged as overdue and escalated up a chain of people until somebody acknowledges it.Sentinel
The scan.
- The imaging request, the porter, the scanner and the report are coordinated by telephone.The request is one order with a live state, and the completed study returns to it and opens in the record.ForgeAtlas
The score.
- Serial neurological scores are written on a bedside chart and lost between shifts, so deterioration is described rather than shown.Scores are forms with their own validation and their own calculators, on the record, comparable across the admission.Glyph
The long disease.
- Epilepsy, Parkinson's disease and multiple sclerosis are managed over years by a patient who travels for each review.Reviews stand as due tasks, and the reminder goes out on a consented channel with a delivery log.QuestRaven
- Neurophysiology studies are ordered on one system and reported on another.One order carries the study to the machine and the report back to the record.Forge
The pathway
Five steps, each one timed and owned.
Arrival
The visit opens and the clock starts on the record rather than on a sheet.
Assessment
The score is a form, filled once, comparable to the next one.
Imaging
One order, a live state, and the study back on the record.
Decision
Recorded with its author and its time, inside the pathway.
Delivery and observation
Doses as due tasks, observations as forms, deterioration as an alert.
The hospital designs the pathway. The platform runs it and keeps the times.