Original Article

Cooperative Efforts Improve Compliance with Acute Stroke Guidelines

Authors: Erfan A. Albakri MD, Ferdinand Richards III MD, Marie Hall RN, Charles Dion MA, Luis S. Miranda MD, Robert Turkel MD, Charles Sand MD, Paulette Vasey MS, ARNP, Kathie McDonald RN, MPH, Mark Michelman MD, MBA, Zaid Smith PHD, Karen Davison RN, Lisa Pfannerstill RN

Abstract

Objective: Guidelines for emergency treatment of stroke are not always known or followed. Florida Medical Quality Assurance, Inc. collaborated with hospitals to determine how closely the current American Heart Association (AHA) and the Florida Agency for Health Care Administration (AHCA) guidelines were being followed and to improve compliance with these guidelines.


Methods: Medical records of patients admitted for acute stroke to 32 hospitals were retrospectively reviewed for compliance with six quality indicators (QIs) on the basis of AHA and AHCA guidelines. Hospitals were provided feedback on their levels of guideline compliance, and they subsequently implemented measures to improve compliance. After 6 months, the records of patients admitted after the provision of feedback were reviewed for compliance with the same six QIs.


Results: Compliance improved with regard to all QIs and was statistically significant for three of them.


Conclusion: Feedback on performance, coupled with proactive collaboration with emergency department staff, resulted in improved compliance with the stroke guidelines.

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