Abstract NS20: Improving Stroke Evidenced-Based Best Practices Across a Multi-State Healthcare System

Abstract

Background and Purpose: As a National effort to provide a framework to improve stroke best practices, a multi- center healthcare system with 48 hospitals across ten states established a stroke collaborative working group. The purpose was to develop a forum to standardize and improve stroke evidenced-based best practices with sister facilities. Methods: A questionnaire was developed and distributed to the stroke collaborative group. A telephone conference was held to review survey results and organizational trends from the 2010 Get With The Guidelines (GWTG) stroke quality metrics. Three quality metrics, dysphagia screening, patient education and door to needle (DTN) were initially identified along with establishing three subcommittees to focus upon improving best practices for each of these measures. Educational webinars, best practice successes and barriers were shared on monthly conference calls as well as a development of an email stroke distribution list serve to improve communication. Results: The three chosen GWTG stroke quality metric score aggregates from 2010 to 2013 second quarter were: dysphagia screen 78.8% to 85.7%, patient education 86% to 94.6%, DTN 60 minutes or less 31% to 72.8% with a mean DTN time of 91 minutes to 68.8 minutes. Conclusion: Formation of a stroke collaborative group for this organization had a positive effect on improving stroke best practices. Areas of focus identified were standardized best practice processes which included creation of system-wide electronic stroke order sets, development of staff and patient educational materials, implementation of templates and development of a DTN challenge. As the Stroke Collaborative expanded three additional working subcommittees were established, Patient Satisfaction, Emergency Medical Service collaboration and Stroke Support Group Development. In conclusion facilitation of communication and collaboration utilizing individual talents and resources is an effective way to improve stroke evidenced-based best practice across a multi-state healthcare system.