We measure our care against the standards in the "Get with the Guidelines" program sponsored by the American Heart Association and the American Stroke Association.
| |
El Camino Hospital Oct-Dec 2012 |
National GWTG Average |
Our Goal |
| Percent who received stroke education (higher is better) |
100% |
93% |
100% |
| Percent of eligible patients who received tPA within three hours (higher is better) |
100% |
93% |
100% |
| Percent of patients for whom rehabilitation was considered (higher is better) |
94% |
98% |
100% |
| Percent of patients who were screened for dysphagia (higher is better) |
92% |
83% |
100% |
| Percent of patients who were prescribed antithrombotic therapy at discharge (higher is better) |
100% |
99% |
100% |
| Percent of patients who were prescribed antithrombotic therapy within two days of their hospital stay (higher is better) |
91% |
98% |
100% |
| Percent of patients who are ambulatory who received DVT prophylaxis by end of hospital day two (higher is better) |
87% |
93% |
100% |
| Percent of patients with atrial fibrillation discharged on anticoagulation therapy (higher is better) |
86% |
96% |
100% |
| Percent of patients with LDL greater than or equal to 100, or LDL not measured, or on cholesterol-reducer prior to admission, who are discharged on Statin medication |
97% |
95% |
100% |
| Percent of patients where CT scan turnaround time is less than 45 minutes |
96% |
not available |
100% |
tPA Within Three Hours
The most promising treatment for ischemic stroke is the FDA-approved clot-busting drug tPA, which must be administered within a three-hour window from the onset of symptoms to work best. Generally, only three to five percent of those who suffer a stroke reach the hospital in time to be considered for this treatment.
Stroke Education
There are many examples of how patient education programs for specific chronic conditions have increased healthful behaviors, improved health status, and/or decreased health care costs of their participants. Clinical practice guidelines include recommendations for patient and family education during hospitalization as well as information about resources for social support services. Some clinical trials have shown measurable benefits in patient and caregiver outcomes with the application of education and support strategies.
This measures the percentage of patients or their caregivers who received education or educational materials during the hospital stay addressing ALL of the following:
- personal risk factors for stroke
- warning signs for stroke
- activation of emergency medical system
- need for follow-up after discharge and
- medications prescribed
Rehabilitation Considered
Approximately two-thirds of stroke patients survive and require rehabilitation. Stroke rehabilitation should begin as soon as the diagnosis of stroke is established and life-threatening problems are under control. Among the high priorities for stroke are to mobilize the patient and encourage resumption of self-care activities as soon as possible. A considerable body of evidence indicates better clinical outcomes when patients with stroke are treated in a setting that provides coordinated, multidisciplinary stroke-related evaluation and services. Learn about our Rehabilitation Services.
This measures the percentage of patients with ischemic, TIA or hemorrhagic stroke who were assessed for rehabilitation services.
Dysphagia Screen
People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.
This measure looks at the percentage of patients who were screened for dysphagia with a simple valid bedside-testing protocol before being given any food, fluids or medication by mouth.
Antithrombotics at Discharge
The term thrombosis means the formation of a thrombus, a type of blood clot. The goals of antithrombotic therapy are to block the formation of new clots, prevent the growth of existing clots, and reduce a person's risk of complications from blood clots.
Data at this time suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and complications as long as there are no medical reasons to avoid it.
This measures the percentage of patients who were prescribed antithrombotic therapy when they were discharged.
Early Antithrombotics
The term thrombosis means the formation of a thrombus, a type of blood clot. The goals of antithrombotic therapy are to block the formation of new clots, prevent the growth of existing clots, and reduce a person's risk of complications from blood clots.
This measures the percentage of patients who received antithrombotic therapy within two days of their hospital stay.
DVT Prophylaxis
Deep vein thrombosis (throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when blood thickens and clumps together. Patients experiencing a stroke that involves a paralyzed lower extremity are at increased risk of developing deep vein thrombosis.
This measures the percentage of patients whose stroke involves a paralyzed lower extremity who received a medication to prevent DVT.
Patients with Atrial Fibrillation Receiving Anticoagulation Therapy
Nonvalvular atrial fibrillation (NVAF) is a common arrhythmia and an important risk factor for stroke. It is one of several conditions that have been identified as risk factors for stroke. Anticoagulants prevent blood from clotting.
Analysis of five placebo-controlled clinical trials investigating the efficacy of warfarin in the primary prevention of thromboembolic stroke, found the relative risk of thromboembolic stroke was reduced by 68 percent for atrial fibrillation patients treated with warfarin. The administration of antithrombotic therapy, unless there are contraindications, is an established effective strategy in preventing recurrent stroke in high stroke risk.
Door-to-CT <3 Hours
Time from triage (ED arrival) to initial imaging work-up for acute stroke or TIA patients.