Benchmarks and determinants of adherence to stroke performance measures.

Abstract

BACKGROUND AND PURPOSE:

Develop achievable benchmarks for 9 stroke performance measures (PM) and to identify organizational factors associated with adherence.

METHODS:

Adherence rates and achievable benchmarks were determined for 9 PM within a study of patients (n=2294) admitted with acute ischemic stroke at 17 hospitals. Baseline information regarding hospital characteristics and stroke-specific processes of care were collected, and multi-level models were used to test the association of these factors with adherence.

RESULTS:

Benchmarks were >or=90% for 8 of the 9 PM. After controlling for clustering, only use of standing orders was associated with adherence to PM, including: dysphagia screening, venous thrombosis prophylaxis, consideration of tPA, and provision of educational material.

CONCLUSIONS:

High levels of adherence are achievable for several acute stroke PM. Use of standing orders is associated with adherence to PM requiring immediate action on admission.

• Authors: Judith A Hinchey, Timothy Shephard, Sarah T Tonn, Robin Ruthazer, Harry P Selker, David M Kent
• Journal: Stroke (Stroke) Vol. 39 Issue 5 Pg. 1619-20 (May 2008) ISSN: 1524-4628 [Electronic] United States
• PMID: 18323510 (Publication Type: Letter, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Fibrinolytic Agents
• Tissue Plasminogen Activator

Topics

• Aged
• Benchmarking (methods)
• Deglutition Disorders (diagnosis, etiology)
• Female
• Fibrinolytic Agents (therapeutic use)
• Guideline Adherence (standards, statistics & numerical data)
• Hospitals (standards, statistics & numerical data)
• Humans
• Longitudinal Studies
• Male
• Outcome Assessment, Health Care (methods)
• Patient Education as Topic (standards, statistics & numerical data)
• Prospective Studies
• Stroke (diagnosis, prevention & control, therapy)
• Tissue Plasminogen Activator (therapeutic use)
• United States
• Venous Thrombosis (drug therapy, prevention & control)