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Updated: Aug 4, 2026
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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Quality improvement in acute stroke: the New York State Stroke Center Designation Project
T I Gropen1, P J Gagliano, C A Blake
1Department of Neurology, Long Island College Hospital and State University of New York-Health Science Center at Brooklyn, 11201, USA. tgropen@chpnet.org
Neurology
|July 13, 2006
Summary
Establishing stroke centers and triaging patients improved acute stroke care. This led to faster treatment with tissue plasminogen activator (t-PA) and increased stroke unit admissions.
Area of Science:
- Neurology
- Emergency Medicine
- Healthcare Management
Background:
- Many hospitals lack adequate infrastructure for acute stroke patient care.
- The Brain Attack Coalition (BAC) established guidelines for primary stroke centers.
- This study evaluated the impact of stroke center designation and patient triage on care quality.
Purpose of the Study:
- To assess if stroke center designation improves acute stroke care quality.
- To determine if selective triage of acute stroke patients enhances treatment outcomes.
- To evaluate the impact on key performance indicators like treatment times and unit admissions.
Main Methods:
- Chart abstraction of stroke patients in 32 New York hospitals (March-May 2002).
- Hospitals were assessed for adherence to BAC guidelines, with on-site verification.
- Post-designation, acute stroke patients underwent selective triage; data collected August-October 2003.
Main Results:
- Median door-to-physician contact time decreased from 25 to 15 minutes.
- Median time for CT scan for t-PA candidates reduced significantly (68 to 32 minutes).
- Intravenous t-PA utilization increased from 2.4% to 5.2%, and stroke unit admissions rose from 16% to 39%.
Conclusions:
- Stroke center designation and selective triage significantly improved acute stroke care.
- Timely access to thrombolytic therapy (t-PA) and stroke unit care was enhanced.
- The findings support the BAC guidelines for improving stroke patient outcomes.
