Stroke Care
These measures go beyond the basic "core measures" and are generally measured and shared by hospitals focusing intensely on quality and service. Some of these measures are not publicly reported to any regulatory agencies but are important in expanding the scope of quality improvement.
tPA Rate
What are we measuring?
The percentage of patients with ischemic strokes (when blood supply to the brain is blocked) arriving at the emergency room who are able to receive tPA (clot dissolving medication) to potentially reverse the effects of an acute stroke.
Why is this important?
tPA is a "clot-busting" medication that can potentially reverse the symptoms and effects of ischemic strokes. It must be given within the first 4.5 hours of the start of symptoms. Because of this narrow window of time and the inavailability of acute stroke management services, the nationwide average for this treatment is less than 5%.
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GWTG Gold Performance Award Measures
IV tPA Within 3 Hours of Symptom Onset
What are we measuring?Antithrombotics by Day 2
The percentage of ischemic stroke patients who arrive at the hospital within 2 hours of the first symptoms of stroke, and who are given IV tPA within 3 hours of the first symptoms.
Why is this important?
tPA is the "clot-busting" drug that can potentially reverse the effects of a major stroke. It must be given within 3 hours of the start of symptoms to be most effective.
Antithrombotics at Discharge
What are we measuring?
The percentage of ischemic stroke patients given antithrombotics by the end of their second day in the hospital.
Why is this important?
Studies have suggested that antithrombotics (medications that reduce the formation of blood clots) should be given within 48 hours of the first symptoms of ischemic stroke to lower the risk of stroke-related morbidity (rate of illness) and mortality (rate of death).
Anticoagulation Therapy for Atrial Fibrillation
What are we measuring?
The percentage of ischemic stroke patients prescribed antithrombotics at discharge.
Why is this important?
Studies have suggested that antithrombotics (medications that reduce the formation of blood clots) should be prescribed at discharge following ischemic stroke to lower the risk of future strokes and stroke-related morbidity (rate of illness) and mortality (rate of death).
DVT Prophylaxis
What are we measuring?
The percentage of ischemic stroke patients with atrial fibrillation that left the hospital on anticoagulation therapy.
Why is this important?
Atrial fibrillation is a common arrhythmia (irregular heartbeat) and is one of the leading causes of stroke. Studies have shown that the risk of stroke was lowered by 68% for atrial fibrillation patients treated with warfarin ("blood thinner" medication). Warfarin and other "blood thinner" medications are effective in preventing strokes from occuring again.
Lipid Lowering Medications at Discharge
What are we measuring?
The percentage of patients with ischemic or hemorrhagic stroke that received preventative measures to avoid blood clots forming in their legs (deep vein thrombosis).
Why is this important?
Patients who suffer strokes and do not move or walk around are at risk for developing blood clots in their legs. This measure looks at our efforts to reduce that risk.
Smoking Cessation
What are we measuring?
The percentage of ischemic stroke patients with an LDL ("bad" cholesterol) level greater than 100, an LDL not measured, or who were on cholesterol-lowering therapy before hospitalization, that are discharged from the hospital on statins (cholesterol-lowering drugs).
Why is this important?
A high serum lipid level is a risk factor for coronary artery disease. Studies have shown that intensive lipid-lowering therapy using statin medication can dramatically lower the chances of future strokes and heart attacks.
What are we measuring?
The percentage of patients with ischemic or hemorrhagic stroke with a history of smoking cigarettes, or their caregivers, who are given smoking cessation advice or counseling during their hospital stay.
Why is this important?
Smoking nearly doubles the risk of ischemic stroke. Studies have shown a large drop in the risk of stroke for former smokers, as well as the death rate from coronary heart disease.
 | California Pacific received the American Stroke Association's Get With The Guidelines®-Stroke Gold Performance Achievement Award by reaching the goal of treating stroke patients with 85% or higher compliance to core standard levels of care. |
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