Construction of a stroke green channel process based on the PDCA cycle management model and its impact on stroke prognosis

Abstract

Objective: To evaluate the impact of implementing a stroke green channel process (GCP) based on the PDCA (Plan-Do-Check-Act) cycle on stroke prognosis.

Methods: A retrospective analysis was conducted at the Second Affiliated Hospital of Guizhou Medical University by reviewing data of 259 stroke patients from January 2021 to December 2023. Patients were divided into two cohorts: 114 patients managed by the PDCA-based GCP and 145 patients receiving standard care (non-green channel process, NGCP). Key metrics assessed included demographic data, rescue indicators, and prognostic outcomes - neurological function, life ability, and quality of life.

Results: The GCP group demonstrated significantly reduced triage (P = 0.009) and computed tomography (CT) scan completion times (P = 0.042), leading to shorter hospital stay durations (P = 0.022) and fewer transfer incidents (P = 0.001). Neurological and cognitive functions improved in the GCP group, evidenced by lower National Institute of Health stroke scale (NIHSS) scores (P = 0.011) and higher Mini-Mental State Examination (MMSE) (P = 0.008) and Montreal Cognitive Assessment (MoCA) scores (P = 0.032). Functional abilities and independence also improved, with higher Activities of Daily Living (ADL) (P = 0.007) and Barthel scores (P = 0.003), alongside lower Modified Rankin Scale (mRS) scores (P < 0.001). Adverse reactions were less frequent in the GCP group (total incidence rate P < 0.001).

Conclusion: Implementing a stroke GCP managed with the PDCA cycle significantly improves stroke prognosis, enhancing clinical outcomes.

Keywords: PDCA cycle; Stroke; emergency care optimization; green channel process; neurological outcomes.

Figure 1

Comparison of neurological function scores between the two groups. A. NIHSS score; B. MMSE score; C. MoCA score. Notes: GCP: green channel process; NGCP: non-green channel process; NIHSS: National Institute of Health stroke scale; MMSE: Mini-Mental State Examination; MoCA: Montreal Cognitive Assessment. *: P < 0.05; **: P < 0.01.

Figure 2

Comparison of functional ability scores between the two groups. A. ADL score; B. Barthel score; C. mRS score. Notes: ADL: Activities of Daily Living; mRS: Modified Rankin Scale. **: P < 0.01; ***: P < 0.001.