Stroke

Stroke Clinical Measures

Clinical Measures Measure Description 2020 Cox Medical Center Springfield GWTG DNV CSC GWTG DNV Goal 2019 National Average
Clinical Measures STK 1: VTE prophylaxis Measure Description Ischemic and hemorrhagic stroke patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission 2020 Cox Medical Center Springfield 96 GWTG DNV CSC 97 GWTG DNV Goal 85 2019 National Average 97.3
Clinical Measures STK 2: Antithrombotics at discharge Measure Description Ischemic stroke patients prescribed antithrombotic therapy at discharge (eg, warfarin, aspirin, other antiplatelet drug) 2020 Cox Medical Center Springfield 100 GWTG DNV CSC 99 GWTG DNV Goal 85 2019 National Average 99.5
Clinical Measures STK 3: Anticoagulation for atrial fibrillation/ atrial flutter Measure Description Ischemic stroke patients with atrial fibrillation/flutter who are prescribed anticoagulation therapy at hospital discharge 2020 Cox Medical Center Springfield 97 GWTG DNV CSC 97 GWTG DNV Goal 85 2019 National Average 97.7
Clinical Measures STK 4: IV t-PA 2 hour, treat by 3 hour Measure Description Acute ischemic stroke patients who arrive at this hospital within 2 hours of time last known well and for whom IV t-PA was initiated at this hospital within 3 hours of time last known well 2020 Cox Medical Center Springfield 100 GWTG DNV CSC 95 GWTG DNV Goal 85 2019 National Average 91.3
Clinical Measures STK 5: Early antithrombics Measure Description Ischemic stroke patients who receive antithrombotic therapy by the end of hospital day 2 2020 Cox Medical Center Springfield 99 GWTG DNV CSC 98 GWTG DNV Goal 85 2019 National Average 97.5
Clinical Measures STK 6: Statins Measure Description Ischemic or hemorrhagic stroke patients or their caregivers who were given educational materials during their hospital stay addressing stroke 2020 Cox Medical Center Springfield 100 GWTG DNV CSC 99 GWTG DNV Goal 85 2019 National Average 98.5
Clinical Measures STK 8: Stroke Education Measure Description Ischemic or hemorrhagic stroke patients or their caregivers who were given educational materials during their hospital stay addressing stroke 2020 Cox Medical Center Springfield 97 GWTG DNV CSC 95 GWTG DNV Goal 85 2019 National Average 96.2
Clinical Measures STK 10: Rehabilitation considered Measure Description Ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services 2020 Cox Medical Center Springfield 100 GWTG DNV CSC 99 GWTG DNV Goal 85 2019 National Average 99.3

DNV Comprehensive Stroke Center

CoxHealth is certified as a DNV Comprehensive Stroke Center (CSC). Comprehensive Stroke Centers represent the most advanced stroke treatment available in a geographic area.

DNV GL's stroke certification programs incorporate elements from our NIAHO® hospital accreditation standards, as well as requirements from the Guidelines of the Brain Attack Coalition and Recommendations of the American Stroke Association.

The emphasis these programs place on deploying a disciplined management system, combined with the relevant clinical best practices, sets DNV GL stroke certifications apart from other programs.

GWTG = Get With The Guidelines, STK = stroke measure set, t-PA = tissue plasminogen activator, VTE = venous thromboembolism

Get With The Guidelines® (GWTG) is the premier hospital-based quality improvement program for the American Heart Association and the American Stroke Association, empowering health care provider teams to consistently treat stroke patients using current evidence-based guidelines. CoxHealth uses the GWTG aggregate comparative data for internal quality improvement, as well as for comparison to other Comprehensive Stroke Centers throughout the nation.

Door-to-Needle Explanation

Target: Stroke, launched by the American Heart Association/American Stroke Association in 2010, is a national quality improvement initiative focused on improving acute ischemic stroke care by reducing door-to-needle times for eligible patients being treated with tPA.

The benefits of tPA in patients with acute ischemic stroke are time-dependent, and guidelines recommend a door-to-needle time of 60 minutes or less. However, studies have found that less than 30 percent of U.S. patients are treated within this window.

Target: Stroke goals have been updated in order to continue to focus on door-to-needle times, as well as endovascular therapy door-to-puncture times.

Target: Stroke aims to continue to reduce door-to-needle times for eligible patients being treated with tPA by establishing more aggressive goals for participating hospitals. The goals for Target: Stroke are:

  • Primary Goal: Achieve door-to-needle times within 60 minutes in 85 percent or more of acute ischemic stroke patients treated with IV tPA.
  • Secondary Goal: Achieve door-to-needle times within 45 minutes in 75 percent or more of acute ischemic stroke patients treated with IV tPA.
  • Achieve door-to-needle times within 30 minutes in 50 percent or more of acute ischemic stroke patients treated with IV tPA.
Clinical Measures Measure Description Time Period Cox South DNVGL Comprehensive Stroke Centers
Clinical Measures Time to Intravenous Thrombolytic Therapy – 30 minutes Measure Description Percent of acute ischemic stroke patients receiving thrombolytic therapy during the hospital stay who have a time from hospital arrival to initial of thrombolytic therapy administration (door-to-needle time) of 30 minutes or less. Time Period 1/1/2020–12/31/2020 Cox South 44.4% DNVGL Comprehensive Stroke Centers 38%
Clinical Measures Time to Intravenous Thrombolytic Therapy – 30 minutes Measure Description Percent of acute ischemic stroke patients receiving thrombolytic therapy during the hospital stay who have a time from hospital arrival to initial of thrombolytic therapy administration (door-to-needle time) of 30 minutes or less. Time Period 1/1/2021–3/31/2021 Cox South 78% DNVGL Comprehensive Stroke Centers 38%
Clinical Measures Time to Intravenous Thrombolytic Therapy – 45 minutes Measure Description Percent of acute ischemic stroke patients receiving thrombolytic therapy during the hospital stay who have a time from hospital arrival to initial of thrombolytic therapy administration (door-to-needle time) of 45 minutes or less. Time Period 1/1/2020–12/31/2020 Cox South 81% DNVGL Comprehensive Stroke Centers 75%
Clinical Measures Time to Intravenous Thrombolytic Therapy – 45 minutes Measure Description Percent of acute ischemic stroke patients receiving thrombolytic therapy during the hospital stay who have a time from hospital arrival to initial of thrombolytic therapy administration (door-to-needle time) of 45 minutes or less. Time Period 1/1/2021–3/31/2021 Cox South 100% DNVGL Comprehensive Stroke Centers 78%
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