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Stroke care improved with guideline-driven approach
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Hospitals that implemented a stroke intervention program improved in several stroke care areas and maintained those results at two years follow-up, according to data presented at the American Stroke Association, International Stroke Conference 2006.
Get With the Guidelines–Stroke (GWTG–Stroke), the American Stroke Association’s voluntary hospital-based quality improvement program, focuses on interventions that reduce complications and prolong life after stroke:
- Using intravenous tissue plasminogen activator (tPA) within three hours after stroke symptom onset,
- Administering antithrombotics within 48 hours of stroke onset,
- Preventing deep vein thrombosis within the first 48 hours,
- Prescribing antithrombotics at discharge,
- Prescribing anticoagulation therapy for atrial fibrillation,
- Treating high cholesterol at discharge,
- Counseling for smoking cessation at discharge,
- Treating diabetes at discharge,
- Counseling for lifestyle changes in obese patients.
To determine the results of implementing GWTG–Stroke on patient care in the acute care setting, researchers analyzed the care of 37,753 patients treated for stroke at 65 U.S. hospitals. The researchers assessed performance measures before the intervention started and every quarter for two years after launching GWTG–Stroke. Researches documented the following:
- Eligible patients receiving tPA rose from 27.6% to 51%,
- 8.4% improvement from baseline to two years in people receiving antithrombotics in the first 48 hours,
- 5.4% improvement in eligible patients receiving antithrombotic prescriptions at discharge,
- 18.2% improvement in eligible patients getting anticoagulation therapy for atrial fibrillation at discharge,
- 25% improvement in the number of people receiving medication for managing cholesterol,
- 37.7% improvement in the number of smokers who received smoking cessation counseling,
- 40.8% improvement in the number of eligible people getting medication for diabetes,
- 12.5% improvement in lifestyle counseling.
The researchers noted a 6.2% reduction in the use of deep vein thrombosis prevention, which may be attributed to an increase in the awareness of the disease and improved detection of patients at risk. For more information on the American Heart Association’s Get With The Guidelines programs, visit Americanheart.org/getwiththeguidelines.