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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

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.

Joint Commission Journal on Quality and Patient Safety

|November 9, 2007

Summary

Implementing a systematic quality improvement (QI) approach in Michigan hospitals significantly enhanced acute stroke care. Key improvements included increased smoking cessation, dysphagia screening, and better documentation for stroke treatments.

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Last Updated: Jul 10, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

Area of Science:

Healthcare Quality Improvement
Stroke Care Management
Public Health Initiatives

Background:

The Paul Coverdell National Acute Stroke Registry identified areas for improvement in acute stroke care within Michigan.
A collaborative effort was initiated to address these opportunities in stroke patient management.

Purpose of the Study:

To evaluate the impact of a collaborative quality improvement (QI) initiative on acute stroke care.
To implement and assess the effectiveness of tailored stroke practice guidelines across multiple hospitals.

Main Methods:

A partnership involving registry investigators, the American Stroke Association (ASA), the Michigan Department of Community Health, and 13 hospitals was formed.
The Institute for Healthcare Improvement Breakthrough Series model and ASA's Get With The Guidelines-Stroke program were utilized.
The Patient Management Tool (PMT) facilitated the implementation of tailored stroke practice guidelines.

Main Results:

Significant improvements (p < .05) were noted in 5 out of 16 quality measures.
Smoking cessation rates increased by 31%.
Dysphagia screening and NIH stroke scale use each increased by 19%.
Documentation of reasons for not using recombinant tissue plasminogen activator (rt-PA) rose by 13%.
Dyslipidemia documentation improved by 9%.

Conclusions:

A collaborative and systematic QI approach can lead to clinically and statistically significant improvements in acute stroke care.
Protocol utilization, ongoing data collection, and review via an organized PMT are key components for successful QI in stroke management.