Abstract NS1: Creating partnerships through the Kansas Initiative for Stroke Survival (KISS)
Background and Purpose: Kansas is a rural state lacking geographically distributed Primary Stroke Centers. Of the 128 hospitals in the state, 88 are designated as Critical Access (< 25 beds). The IV r-tPA treatment rate in the state of Kansas is less than 2%. The pre-transport death rate for patients experiencing stroke is 55.4% .The Kansas Initiative for Stroke Survival (KISS) is a non-government task force with the goal of improving stroke survival among Kansans. The task force encourages hospitals to meet the criteria as Emergent Stroke Ready and based on this status engage with their individual communities, emphasizing the need to seek immediate assistance by EMS and arrive at the closest Emergent Stroke Ready hospital.
Methods: The Kansas State Stroke Task force determined requirements for a facility to be considered Emergent Stroke Ready. This information was distributed to all acute care hospitals, asking them to attest to their current Emergent Stroke Ready status. Responding facilities were provided access to a 24 x 7 Stroke Support Line - providing access to stroke specialists for the purpose of guiding evaluation and treatment decisions for r-tPA administration or need to transfer to a higher level of care. Also provided is a community education kit. Data is reported through a monthly online survey or GWTG database.
Results: In the first phase of the KISS project - forty-two hospitals attested as Emergent Stroke Ready Hospital or were certified Primary Stroke Centers representing an increase from 7% to 33% of hospitals in the state. The post-KISS implementation IV r-tPA treatment rate for the reporting Emergent Stroke Ready Hospitals was 48% compared with a pre-KISS treatment rate of 6%. The post-KISS implementation transfer rate was 26.7% compared with a pre-KISS transfer rate of 18%.
Conclusions: The KISS program resulted in a significant increase in the number of Emergent Stroke Ready facilities, stroke patients reporting to their local hospitals, stroke specialist consultations and use of IV r-tPA. A low-cost, statewide program that provides standardized protocols and direct phone consultation can improve access to stroke specialists and approved stroke treatment while offering a cost effective, feasible alternative to telestroke.
- © 2012 by American Heart Association, Inc.