Use of a prototype acute stroke registry to improve care: profile of receptive stroke programs

A Wave-II Paul Coverdell Prototype Acute Stroke Registry collected data from 16 hospitals of various sizes and types in Oregon. The goal of this study was to identify whether particular process or structural characteristics of stroke programs in these hospitals were related to the use of reports from the prototype registry to improve care. Researchers surveyed hospitals to ask whether ongoing data completeness reports and monthly comparative quality reports were used to make changes in the acute care process. These self-reports were then confirmed by using the registry data to construct objective run-chart measures over 12 months. Results showed several programmatic characteristics that distinguished programs that used quality reports to make improvements. Hospitals that ignored monthly reports of key performance indicators showed either zero or one positive trend across seven preselected quality indicators. This finding is in contrast to the range of one to four positive changes in quality indicators for report users. Three main characteristics seem to define report users who could translate ongoing findings into potential care improvements: (1) documentation of care processes across departments; (2) access to local or remote stroke teams; and (3) data-collection experiences such as clinical trials, National Institutes of Health Stroke Scale (NIHSS), and outcome feedback. This study could lead to a better understanding as to which characteristics of stroke programs are most important for making rapid improvements for stroke care.