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GMC Streamlines Processes to Improve Stroke Patients’ Outcomes


Gwinnett Medical Center has received the Georgia Coverdell Acute Stroke Registry (GCASR) Door to Needle Time (DTN) Award for 2013. The Door to Needle Time Award recognizes GMC for meeting this “golden hour” for stroke care and having a 20 percent decrease in door to needle time.

GMC is one of only five hospital systems in the Georgia Coverdell Registry to receive this award for improvement, and one of only nine hospital systems in the state to achieve this 60-minute DTN level of stroke care.  

“During a stroke, every minute means 1.9 million neurons, or brain processing cells, are lost,” said Susan Gaunt, MS, APRN, GMC’s Stroke Program Coordinator/Clinical Nurse Specialist.   “So time is really brain. That is why it is critical to call 911 if you think you are having a stroke.”

Named in honor of the late Senator Paul Coverdell, who died of a massive stroke, the Georgia Coverdell Acute Stroke Registry has identified 60 minutes as the “golden hour” for hospitals to evaluate and determine appropriate treatment for stroke patients.

Door to needle time refers to the time it takes to evaluate and administer tPA, a clot-busting drug that can potentially minimize or reverse the effect of stroke. This evaluation includes a thorough history, physical exam, CT scan, lab tests, and interpretion of the results to see if the patient meets criteria for tPA.

“In addition to losing neurons with every minute,” added Gaunt, “Time matters because tPA is effective only within the first three hours from when the stroke begins. Since many people do not recognize they are having a stroke, the faster the ED can perform the tests to determine if the patient is a candidate for tPA, the better.”

As part of GMC’s continuum of stroke care, the emergency departments at both GMC-Lawrenceville and GMC-Duluth improved door to needle time through streamlining internal processes. This is part of GMC’s on-going effort to improve quality of care for patients.

“Beginning March 1, 2013,” said Gaunt, “GMC and Gwinnett County Emergency Medical Services are partnering to further improve door to needle time by initiating a new process that will begin at the time EMS arrives on the scene.”   

GMC’s Lawrenceville and Duluth emergency departments together see approximately 11,000 patients each month.  Fifty to seventy of these patients are diagnosed with a stroke. “If we are lucky,” said Gaunt, “ten of these patients realize they are having a stroke and arrive within the first three hours from onset of symptoms. While not all those are candidates for tPA, for those who are, it can significantly improve the outcome.”

About Gwinnett Medical Center

Gwinnett Medical Center is a nationally-recognized, not-for-profit healthcare network with acute-care hospitals in Lawrenceville and Duluth. Offering cardiovascular, orthopedic and neuroscience specialty care as well as a full continuum of wellness services, GMC’s 4,500 associates and 800 affiliated physicians serve more than 400,000 patients annually. To learn more about how GMC is transforming healthcare, visit or follow us at, or