Compliance with joint commission measures in state-designated stroke centers

Area of Science:

• Neurology
• Healthcare Quality
• Public Health

Background:

• Limited data exist comparing state-designated primary and comprehensive stroke centers (PSCs and CSCs) on adherence to national stroke performance standards.
• This study investigates the association between stroke center designation level and compliance with Joint Commission (JC) stroke core measures.

Purpose of the Study:

• To determine if comprehensive stroke centers (CSCs) demonstrate superior adherence to Joint Commission stroke core measures compared to primary stroke centers (PSCs).
• To compare door-to-thrombolytic times between CSCs and PSCs.

Main Methods:

• Retrospective analysis of the New Jersey acute stroke registry (2010-2011).
• Comparison of JC core measures and median door-to-thrombolytic times between PSCs and CSCs.
• Adjusted odds ratios (aOR) calculated to assess the association between hospital level and measure fulfillment.

Main Results:

• Analysis included 36,892 acute stroke admissions; 60% in PSCs, 40% in CSCs.
• CSCs adhered better to 6 of 8 JC measures.
• Thrombolytic therapy was administered to 19.5% of eligible patients at CSCs versus 9.6% at PSCs (aOR = 0.28).
• Median door-to-thrombolytic drug times were significantly shorter at CSCs (65 minutes) compared to PSCs (74 minutes).

Conclusions:

• New Jersey's comprehensive stroke centers (CSCs) exhibit superior adherence to Joint Commission stroke core measures.
• CSCs demonstrate significantly shorter door-to-thrombolytic drug times, indicating more efficient acute stroke care delivery.