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Updated: Jul 10, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Closing gaps between evidence-based stroke care guidelines and practices with a collaborative quality improvement
Stacey Stoeckle-Roberts1, Mathew J Reeves, Bradley S Jacobs
1American Heart Association, Greater Midwest Affiliate, Southfield, Michigan, USA.
Background:
Michigan's prototype of the Paul Coverdell National Acute Stroke Registry revealed improvement opportunities in acute stroke care.
Methods:
A partnership among the registry investigators, American Stroke Association (ASA), Michigan Department of Community Health, and 13 Michigan hospitals was implemented in 2004. The Institute for Healthcare Improvement Breakthrough Series model and the ASA's Get With The Guidelines-Stroke program and Patient Management Tool (PMT) were used to implement tailored stroke practice guidelines at each hospital.
Results:
Significant improvements (p < .05) were observed for 5 of the 16 measures. Smoking cessation increased by 31%, dysphagia screening increased by 19%, use of the NIH stroke scale increased by 19%, documentation of reasons for not using recombinant tissue plasminogen activator (rt-PA) increased 13%, and documentation of dyslipidemia increased by 9%.
Discussion:
Clinically and statistically significant improvements can be made in acute stroke care using a collaborative and systematic approach to QI that employs protocol utilization and ongoing data collection and review as part of an organized PMT.
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Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
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