Neurological emergency medical treatment efforts by two hospitals with different medical areas for acute care: Construction of an emergency medical care system using a social networking service

<p>  We describe a successful collaboration between two public acute care hospitals in Japan’s Shiga prefecture: Otsu City Hospital and Saiseikai Shiga Hospital. These hospitals are situated in different medical areas, and each is responsible for secondary and tertiary emergency care. Leveraging their geographical proximity and staff interactions, the two hospitals developed a coordinated system to enhance their neurosurgical and neurological emergency care capabilities. This collaboration was achieved through the use of social networking service (SNS) tools, enabling real‒time communication and data‒sharing between neurosurgeons and neurologists at the two institutions. The coordinated system is designed to streamline the treatment process for patients with urgent needs, particularly those with critical neurological conditions. After implementing the collaborative system in 2022, Otsu City Hospital handled approx. 1,080 neurological emergency patients annually, with 224 of these patients requiring hospitalization; in addition, 29 emergency cases were transferred to Saiseikai Shiga Hospital. Among these transfers, 10 were categorized as ultra‒urgent cases, including critical conditions such as main cerebral artery occlusion and impending cerebral hernia. Among these 10 cases, seven patients with main cerebral artery occlusion underwent a mechanical thrombectomy. The average time from the contact with a consultant to the initiation of treatment for these 10 patients was 103.4 ± 44.7 min, with six patients (67%) achieving effective reperfusion with Thrombolysis in Cerebral Infarction (TICI) scores ≥ 2 points. Our comparison of the pre‒system implementation data from Otsu City Hospital (in which six mechanical thrombectomies were performed over a 3‒year period) identified no significant difference in the waiting time for diagnosis and treatment, with an average of 101.1 ± 27.8 min. In today’s highly specialized medical landscape, collaboration between acute‒care institutions with different characteristics presents an opportunity to complement weaknesses and leverage strengths. However, examples of close cooperation between two acute‒care hospitals in the field of neurological emergency care are scarce. The present system, which established a highly effective and close inter‒hospital collaboration for neurological emergency cases through the use of SNS groups among staff, demonstrates the potential of such approaches to contribute to regional healthcare improvement.</p>