Date of Award

Spring 2021

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chairperson

Veronica Wilbur, Ph.D, APRN, CNE, FAANP


Acute ischemic stroke is the interruption of blood flow to the brain. Each minute of ischemia causes the death of 1.9 million neurons, making treatment for acute ischemic stroke exceedingly time sensitive. Treatment decisions require complex imaging and evaluation. Specialized teams including Neurologists, pharmacists and CT technicians are alerted to the ED when a patient presents with signs or symptoms of acute ischemic stroke to carry out these evaluations. In the Hospital of the University of Pennsylvania ED, these alerts were delivered via a de-identified text message, preventing the collection of data needed for clinical effectiveness and quality improvement work. The purpose of this project was to improve the Stroke Alert process using Computerized Physician Order Entry (CPOE) to initiate the alert via a HIPAA Compliant Group Messaging (HCGM) application called Haiku. Haiku is an application available in Penn Chart, the hospital’s electronic health record, which allows for retrieval of data unavailable when utilizing the de-identified alerting method. Data on Stroke Alert volumes from 6 weeks prior to implementation of the Haiku Stroke Alert was compared to volumes 6 weeks after implementation. A comparison of Door to CT and Door to Needle times in those periods were also compared to ensure the new process did not cause any delays in these metrics. Results showed the CPOE based Haiku Stroke Alert process was easily adopted, and allowed for access to data necessary for clinical effectiveness and quality improvement work without causing delays in Door to CT or Door to Needle times.