Weekend Discharge and Stroke Quality of Care: Get With The Guidelines-Stroke Data from a Comprehensive Stroke Center

Weekend Effect on in-Hospital Mortality for Ischemic and Hemorrhagic Stroke in US Rural and Urban Hospitals

“…Emergency department errors associated with temporary staff have been found to be more harmful than those associated with permanent staff (including life-threatening errors) 24 , though there was no documented linkage between stroke mortality and staffing with contracted professionals. Patients discharged on the weekends were significantly less likely to receive stroke education and weight reduction counseling suggesting that the quality of care may be compromised on weekends for both stroke types 25 . To our knowledge, our study is the first to examine the weekend effect on stroke mortality by stroke type and urban-rural status of the hospital.…”

Weekend hospital discharge is associated with suboptimal care and outcomes: An observational Australian Stroke Clinical Registry study

“…We have identified a patient subgroup (e.g., patients discharged on the weekend) who are at risk of not receiving recommended clinical processes of care. In a study by Starr et al 7 in the United States of 2737 stroke admissions, patients discharged on weekends were less likely to receive evidence-based education and weight reduction counseling after stroke. 7 Our study provides additional data that patients who were not treated in a stroke unit were more likely to be discharged on a weekend (with a lower chance of receiving other evidence-based discharge processes of care).…”

“…7 in the United States of 2737 stroke admissions, patients discharged on weekends were less likely to receive evidence-based education and weight reduction counseling after stroke. 7 Our study provides additional data that patients who were not treated in a stroke unit were more likely to be discharged on a weekend (with a lower chance of receiving other evidence-based discharge processes of care). More importantly, these patients who were discharged on the weekend were less likely to receive important discharge quality of care processes such as antihypertensive medication.…”

“…A small study of 2737 patients participating in Get With the Guidelines with stroke reported that weekend discharge was independently associated with a one-third reduction in the odds of receiving stroke education and weight reduction counseling. 7 Our aim was to compare quality of care and outcomes for weekend versus weekday discharge after stroke/transient ischemic attack (TIA) using data collected in the Australian Stroke Clinical Registry (AuSCR). We hypothesized that patients discharged on the weekend would be less likely to receive the recommended quality of care indicators and have worse outcomes.…”

Insights Into Oropharyngeal Dysphagia From Administrative Data and Clinical Registries: A Literature Review

“…Screening rates have been shown to vary with patient age, race (Black, Asian, Hispanic > White), stroke type (intracranial hemorrhage > ischemic stroke), stroke severity, off-hour admission, July admission, community versus in-hospital stroke, insurance status, academic hospital status, and history of atrial fibrillation (James et al, 2014;Joundi et al, 2017;Masrur et al, 2013;Park, Redelmeier, Li, Pongmoragot, & Saposnik, 2015;Reeves et al, 2009;Saltman et al, 2015;Saposnik et al, 2009;Smith et al, 2009;Xian et al, 2014). Screening rates do not vary by patient sex, smoking status, or weekend admission (Ali, Smith, Bhatt, Fonarow, & Schwamm, 2013;Fang, Saposnik, Silver, & Kapral, 2010;Kapral et al, 2011;Starr, Becker, & Tirschwell, 2016). There has been some exploration into increasing dysphagia screening rates using various programs (Hinchey et al, 2010;Stoeckle-Roberts et al, 2006).…”