Evidence-based Stroke Quality Improvement Programs for CAHs

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Completed Project


The purposes of this project were to identify successful evidence-based programs to improve stroke care that could be replicated in CAHs and disseminate information about these programs to State Flex Programs. This project resulted in a policy brief including information on successful stroke QI programs applicable to CAHs. 

Stroke is the 6th highest diagnosis among CAH emergency department Medicare claims resulting in transfer to another hospital for inpatient care, and the 7th highest diagnosis among claims resulting in a same-hospital inpatient hospitalization. Stroke has a high mortality rate: 10.3% of stroke hospitalizations resulted in death in 2005-2006. Several studies have found that CAHs and other rural hospitals are less likely than large urban facilities to provide recommended care for stroke patients. Programs such as the American Heart Association’s “Get with the Guidelines–Stroke,” the CDC’s Coverdell National Acute Stroke Registry program, and a number of state initiatives focus on improving care for stroke patients. Quality measures to assess stroke care are included in Hospital Compare/Joint Commission inpatient measures and EHR meaningful use clinical measures; for 2015, between 105 and 303 CAHs publicly reported data on each of the stroke measures to Hospital Compare.