Abstract 2533: Statewide System Approach has Positive Impact on Stroke Care
Background and Issues: Approximately 83% of acute-care hospitals in Maryland are designated as primary stroke centers. The Maryland Stroke Center Consortium (MSCC) is a network of representatives from all hospitals in the state of Maryland that have been designated as stroke centers. In collaboration with the Maryland Institute of Emergency Medicine Services Systems (MIEMSS)--the body that provides state oversight, the American Heart Association (AHA), and the Maryland Stroke Alliance (MSA), the MSCC works to improve stroke care outcomes statewide. Since 2007, the MSCC has met bi-monthly to network, review data, mentor, educate, and share best practices. Registry participation and data collection are standardized across the state.
Purpose: To determine if a statewide consortium can have a positive impact on the quality of care for patients with stroke via the nursing-focused measures of Dysphagia Screening and Patient Education.
Methods: All primary stroke centers in Maryland participate in AHA’s Get with the Guidelines (GWTG) Stroke Program. Data were collected using the internet-based Patient Management ToolTM (Outcome, Inc.). A 4-year retrospective review was performed of the Stroke Core Measures and Dysphagia Screening data in the Maryland Stroke Registry.
Results: Although over time, improvement was seen in all Stroke Core Measures at both state and national levels, in 2010, Maryland stroke centers demonstrated a higher level of compliance in seven measures compared to all centers participating in the GWTG stroke registry. Moreover, statistically significant higher levels of compliance were found for Dysphagia Screening (82.1% versus 78.3%, p = <0.01) and Patient Education (85.4% versus 81.1%, p = <0.01).
Conclusions: Participation in a statewide consortium, paired with oversight at the state level, results in a positive impact on the quality of stroke care and patient outcomes. The critical thinking, open communication, and sharing of information that occur at the consortium level translate into improved care consistent with evidence-based best practices at individual facilities.
- © 2012 by American Heart Association, Inc.