Evaluating stroke metrics for all acute ischemic stroke (all-AIS) patients can help promote change and optimize programs
Acknowledge successes and mind the gaps
How do you communicate insights and drive actions to improve patient care? Broadly disseminating successful quality strategies is critical to maximizing the benefits of individual improvement programs. A small and successful quality initiative can be distilled into a step-by-step process that can be replicated at facilities nationwide. 19
Concise, consistent communication is critical to driving ongoing improvements and can align your team on common goals and actionable insights.
Communicate with physicians and staff in terms of process by:
- Staging one-on-one discussions and communicate without assigning blame or making it personal
- Highlighting successes as well as challenges
- Utilizing negative-free
language that stresses "can-do" information
Report the right metrics to the right people
- Who else should be aware of program findings (ie, reporting the right metrics/findings to the right people)?
Take action: share metrics with your stroke team
Monthly reporting templates, such as a simple grid, can be an
effective tool for communicating key metrics to your stroke team. This
reporting format could be adapted for different teams with different
AIS, acute ischemic stroke; DTN, door-to-needle time; mRS, modified Rankin Scale, sICH, symptomatic intracranial hemorrhage
Using metrics to empower your team in the stroke process
Average DTN time communicates how quickly patients are being treated
with Activase once they arrive at the center. It is one measure which
may speak to the efficiency of your stroke program.
Track average door-to-needle (DTN) time monthly
- Assess how your institution is doing compared to established benchmarks (eg, Target: Stroke time goals) and to your own established target time
- Evaluate your average DTN time goals
- Communicate your results by incorporating them into your regularly scheduled presentations and/or posting them on bulletin boards. Use our feedback tool
Using metrics to empower your team to make process improvements
An all-AIS treatment rate communicates how many patients with a discharge diagnosis of AIS were treated with Activase. By accounting for every patient discharged with a confirmed AIS diagnosis and tracking an all-AIS rate, stroke coordinators can use data trends to:
- Assess how the stroke process accounts for all patients with AIS that flow through the hospital
- Better understand why patients are excluded and how they align to hospital protocols
Tracking the percentage of patients with symptomatic intracranial hemorrhage (sICH) is one of the important safety measures for your hospital to track. Tracking the modified Rankin Scale (mRS) at discharge helps assess whether patients have benefited. mRS scores of 2 or more indicate the presence of disability.
Track key metrics monthly
- Assess how your institution is doing compared to established benchmarks as well as your own target goals
- Communicate results by incorporating them into your regularly scheduled presentations and/or posting them on bulletin boards. Use our feedback loop tool
Work with stroke champions in your team to report successes and promote change:
- Promote community awareness and emergency medical services education
- Revisit hospital protocols, including order sets/processes, patient arrival, and hospital training
- Review identified patient types at monthly meetings
How often do you share metrics results with your stroke team: monthly, quarterly, bi-annually, annually, or other?