Abstract T P256: Is The Collection of Stroke Data to Improve Patient Care Important for Small Volume Hospitals?

• Published in: Stroke (1970) 2015-02, Vol.46 (suppl_1)
• Main Authors: Prabhakaran, Shyam, Jones, Peggy, Ward, Jody, Miller, Kathryn, O'Neill, Kathleen, Gardner, Michelle
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.46.suppl_1.tp256

Abstract only Background: Stroke continues to be a significant cause of morbidity and mortality in the Midwest. Often times, CAHs are the first facility that see stroke patients. CAHs often have internal barriers and pushback of stroke quality efforts based on patient volume. Purpose: To evaluate the impact of data collection on improving patient outcomes in small volume hospitals through the examination of data trends. Methods: A benchmarking group of CAHs was created through the Get With The Guidelines-Stroke Patient Management Tool. The majority of the hospitals were from Wisconsin, Illinois and North Dakota. The number of hospitals in the benchmark has varied. At the highest point in 2010-2011, there were 44 CAHs collecting data. The CAH hospitals have entered data for over 4500 stroke and TIA patients from 2009-2014 . Data was pulled from 2006-2013 to examine the CAH trends in compliance of tPA and the in-hospital and secondary prevention measures. We also assessed the composite score comprised of tPA for eligible patients and 6 other in-hospital and secondary prevention measures. Results: It was clear that more stroke or TIA patients coming into the CAHs were being admitted to the CAH instead of being transferred. It was also noted that the composite scores of these hospitals improved each year through the collection and monitoring of data showing improvement from 55% in 2006 to 83% in 2013. The rate of IV-tPA among patients that arrive within 2 hours and treated within 3 hours has remained stable around 40% since 2009, but the number of patients receiving tPA has increased dramatically in CAHs since 2008. The VTE prophylaxis, LDL assessment, and antithrombotic measures have improved every year since 2010. Anticoagualtion for atrial fibrillation is now at 90% compliance. Conclusion: The data provides evidence that more patients are getting tPA at CAHs but less than half of these eligible patients met the measure of 2 hour arrival treat in 3 hours.Data collection and review has improved the in-hospital and secondary prevention measures for the 69% of patients that are admitted to the CAH. Data collection and ongoing improvement activities, even with small volumes, improves adherence to guidelines and can be beneficial for small volume hospitals.