scholarly journals Quality of acute stroke care in a regional Victorian hospital, Australia

2019 ◽  
Vol 27 (2) ◽  
pp. 153-157
Author(s):  
Tze Wei Wilson Yang ◽  
Md Rafiqul Islam
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care

FP22-TU-01 Quality of acute stroke care in Thailand, a prospective multicenter countrywide study

2009 ◽  
Vol 285 ◽  
pp. S91
Author(s):  
Y. Nilanont ◽  
S. Nidhinandana ◽  
N. Suwanwela ◽  
N. Poungvarin
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care

Abstract W MP104: Quality of Acute Stroke Care at Primary Stroke Centers Before and After Certification in Comparison to Never-Certified Hospitals

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Nerses Sanossian ◽  
May A Kim-Tenser ◽  
David S Liebeskind ◽  
Justina Breen ◽  
Scott Hamilton ◽  
...  
Keyword(s):  
Los Angeles ◽  
Acute Stroke ◽  
Stroke Care ◽  
Care Quality ◽  
Acute Stroke Care ◽  
Phase 3 ◽  
Before And After ◽  
Beneficial Impact ◽  
Mean Time

Background: Primary Stroke Centers (PSC) provide better acute stroke care than non-PSC hospitals, including faster times to imaging and lytic treatment, and higher rates of lytic delivery. Nationwide less than 1 in 3 hospital has achieved this designation. We aimed to determine the extent to which the better performance at PSC is driven by improvements within hospitals after PSC designation versus better baseline hospital care among facilities seeking PSC certification. Methods: From 2005 to 2012, the NIH Field Administration of Stroke Therapy -Magnesium (FAST-MAG) Phase 3 clinical trial enrolled subjects with likely stroke within 2 hours of onset in a study of prehospital start of a neuroprotective agent. Subjects were routed to 59 community and academic centers in Los Angeles and Orange Counties. Of the original 59 centers, 39 eventually achieved PSC status during the study period. Each subject was classified as enrolled at a PSC before certification (pre-PSC), at a PSC post certification (post-PSC), or at a hospital that never achieved PSC (non-PSC). Results: Of 1700 cases, 529 (31%) were enrolled at pre-PSC, 856 (50%) at post-PSC, and 315 (19%) at non-PSC hospitals. Mean time in minutes from ED arrival to first scan was 33 minutes at post-PSC, 47 minutes at pre-PSC and 49 at non-PSCs [p<0.001 by Mann-Whitney]. Among cases of cerebral ischemia (CI) [N=1223], rates of TPA utilization were 43% at post-PSC, 27% at pre-PSC and 28% at non-PSC hospitals [p<0.001 by X2]. Time in minutes from ED arrival to thrombolysis in treated cases was 71 at post-PSC, 98 at pre-PSC, and 95 at non-PSC hospitals [p<0.001 by Mann-Whitney]. Hospitals that achieved PSC showed improvements in pre-PSC and post-PSC performance on door to imaging time, from 47 to 33 minutes [p=0.014]; percent TPA use in CI, from 27% to 43% [p<0.001], and reduced door-to-needle times, from 98 to 71 minutes [p=0.003]. There was no difference in time to imaging [47 vs. 49 minutes], time to thrombolysis [98 vs. 95 minutes] and percent TPA use [27% vs. 28%] between pre-PSC hospitals and non-PSC hospitals. Conclusions: Better performance of Primary Stroke Centers on acute care quality metrics is primarily driven by a beneficial impact of the PSC-certification process, and not better performance prior to seeking PSC status.

scholarly journals Effects of centralizing acute stroke services

Neurology ◽  
2018 ◽  
Vol 91 (3) ◽  
pp. e236-e248 ◽  
Author(s):  
Sidsel Hastrup ◽  
Soren P. Johnsen ◽  
Thorkild Terkelsen ◽  
Heidi H. Hundborg ◽  
Paul von Weitzel-Mudersbach ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Acute Stroke ◽  
Stroke Care ◽  
Acute Hospital ◽  
Acute Stroke Care ◽  
Difference In Differences ◽  
Stroke Units ◽  
Before And After ◽  
Stroke Services

ObjectiveTo investigate the effects of centralizing the acute stroke services in the Central Denmark Region (CDR).MethodsThe CDR (1.3 million inhabitants) centralized acute stroke care from 6 to 2 designated acute stroke units with 7-day outpatient clinics. We performed a prospective “before-and-after” cohort study comparing all strokes from the CDR with strokes in the rest of Denmark to discover underlying general trends, adopting a difference-in-differences approach. The population comprised 22,141 stroke cases hospitalized from May 2011 to April 2012 and May 2013 to April 2014.ResultsCentralization was associated with a significant reduction in length of acute hospital stay from a median of 5 to 2 days with a length-of-stay ratio of 0.53 (95% confidence interval 0.38–0.75, data adjusted) with no corresponding change seen in the rest of Denmark. Similarly, centralization led to a significant increase in strokes with same-day admission (mainly outpatients), whereas this remained unchanged in the rest of Denmark. We observed a significant improvement in quality of care captured in 11 process performance measures in both the CDR and the rest of Denmark. Centralization was associated with a nonsignificant increase in thrombolysis rate. We observed a slight increase in readmissions at day 30, but this was not significantly different from the general trend. Mortality at days 30 and 365 remained unchanged, as in the rest of Denmark.ConclusionsCentralizing acute stroke care in the CDR significantly reduced the length of acute hospital stay without compromising quality. Readmissions and mortality stayed comparable to the rest of Denmark.

scholarly journals Quality of Acute Stroke Care at Primary Stroke Centers Before and After Certification in Comparison to Never-Certified Hospitals

2020 ◽  
Vol 10 ◽  
Author(s):  
Kristina Shkirkova ◽  
Theodore T. Wang ◽  
Lily Vartanyan ◽  
David S. Liebeskind ◽  
Marc Eckstein ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care ◽  
Before And After

scholarly journals The Dutch Acute Stroke Audit: Benchmarking acute stroke care in the Netherlands

2018 ◽  
Vol 3 (4) ◽  
pp. 361-368 ◽  
Author(s):  
Laurien S Kuhrij ◽  
Michel WJM Wouters ◽  
Renske M van den Berg-Vos ◽  
Frank-Erik de Leeuw ◽  
Paul J Nederkoorn
Keyword(s):  
Acute Stroke ◽  
Best Practice ◽  
Intravenous Thrombolysis ◽  
Stroke Care ◽  
Favourable Outcome ◽  
Hospital Level ◽  
Acute Stroke Care ◽  
Related Factors ◽  
Variation In Care

Introduction In the nationwide Dutch Acute Stroke Audit (DASA), consecutive patients with acute ischaemic stroke (AIS) and intracranial haemorrhage (ICH) are prospectively registered. Acute stroke care is a rapidly evolving field in which intravenous thrombolysis (IVT) and intra-arterial thrombectomy (IAT) play a crucial role in increasing odds of favourable outcome. The DASA can be used to assess the variation in care between hospitals and develop ‘best practice’ in acute stroke care. Patients and methods: We describe the initiation and design of the DASA as well as the results from 2015 and 2016. Results In 2015 and 2016, 55,854 patients with AIS and 7727 patients with ICH were registered in the DASA. Treatment with IVT was administered to 10,637 patients (with an increase of 1.3% in 2016) and 1740 patients underwent IAT (with an increase of 1% in 2016). Median door-to-needle time for IVT and median door-to-groin time for IAT have decreased from 27 to 25 min and 66 to 64 min, respectively. Mortality during admission was 4.9% in patients with AIS, whereas 26% of patients with ICH died. Modified Rankin Scale score at three months was registered in 49% of AIS patients and 45% of ICH patients. Discussion During the nationwide DASA, time to treatment is reduced for IVT as well as IAT. With the rapidly evolving treatment of acute stroke care, the DASA can be used to monitor the quality provided on patient- and hospital level. Conclusion Increasing completeness of registration of the outcome, in combination with adjustment for patient-related factors, is necessary to define and further improve the quality of the acute stroke care.

scholarly journals The Quality of Acute Stroke Care

2014 ◽  
Author(s):  
Günter Seidel ◽  
Peter Hermanek ◽  
Peter Kolominsky-Rabas ◽  
Christine Matthis ◽  
Christoph Burmeister ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care

Convincing quality of acute stroke care in TeleStroke Units

2015 ◽  
Vol 4 (2) ◽  
pp. 53-61 ◽  
Author(s):  
P. Müller-Barna ◽  
S. Boy ◽  
G.J. Hubert ◽  
R.L. Haberl
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care

scholarly journals Socioeconomic Status and the Quality of Acute Stroke Care

Stroke ◽  
2016 ◽  
Vol 47 (11) ◽  
pp. 2836-2842 ◽  
Author(s):  
Yuesong Pan ◽  
Ruoling Chen ◽  
Zixiao Li ◽  
Hao Li ◽  
Xingquan Zhao ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care

scholarly journals Development and Implementation of Evidence-Based Indicators for Measuring Quality of Acute Stroke Care

Stroke ◽  
2006 ◽  
Vol 37 (10) ◽  
pp. 2573-2551 ◽  
Author(s):  
Peter U. Heuschmann ◽  
Marcel K. Biegler ◽  
Otto Busse ◽  
Susanne Elsner ◽  
Armin Grau ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Evidence Based ◽  
Acute Stroke Care

The Quality of Discharge Care Planning in Acute Stroke Care: Influencing Factors and Association with Postdischarge Outcomes

2018 ◽  
Vol 27 (3) ◽  
pp. 583-590 ◽  
Author(s):  
Nadine E. Andrew ◽  
Doreen Busingye ◽  
Natasha A. Lannin ◽  
Monique F. Kilkenny ◽  
Dominique A. Cadilhac
Keyword(s):  
Acute Stroke ◽  
Influencing Factors ◽  
Stroke Care ◽  
Care Planning ◽  
Acute Stroke Care ◽  
Discharge Care
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