Related Experiment Video
Updated: Apr 26, 2026
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
Development and initial testing of the stroke rapid-treatment readiness tool
DaiWai M Olson1, Margueritte Cox, Mark Constable
1Questions or comments about this article may be directed to DaiWai M. Olson, PhD RN CCRN, at DaiWai.Olson@UTSouthwestern.edu. He is an Associate Professor of Neurology and Neurotherapeutics at the University of Texas Southwestern Medical Center, Dallas, TX. Margueritte Cox, MS, is a Biostatistician at Duke Clinical Research Institute, Durham, NC. Mark Constable, RN, is a Stroke Coordinater at Duke Clinical Research Institute and Duke University, Durham, NC. Gavin W. Britz, MD, is a Professor of Neurosurgery and the Chairman of Neurosurgery at Methodist Hospital, Houston, TX. Cheryl B. Lin, MD, is a Medical Resident at Duke Clinical Research Institute and Duke University, Durham, NC. Louise O. Zimmer, MPH, is a Clinical Research Coordinator at University of North Carolina at Chapel Hill, Chapel Hill, NC. Gregg C. Fonarow, MD, is a Professor of Medicine and Associate Chief of Cardiology at University of California Los Angeles, Los Angeles, CA. Lee H. Schwamm, MD, is a Professor of Neurology at Harvard University and Vice Chairman of Neurology at Massachusetts General Hospital, Boston, MA. Eric D. Peterson, MD MPH, is a Professor of Medicine at Duke Clinical Research Institute and Duke University, Durham, NC.
A new survey helps hospitals assess their readiness to give tissue plasminogen activator for ischemic stroke. This tool identifies areas for improvement to reduce door-to-needle times, enhancing patient care.
Area of Science:
- Neurology
- Health Services Research
- Quality Improvement Science
Background:
- Timely administration of intravenous tissue plasminogen activator (IV tPA) is critical for treating ischemic stroke.
- Current tools are lacking for health systems to pinpoint areas for reducing door-to-needle times.
- Optimizing IV tPA delivery is essential for improving patient outcomes in acute ischemic stroke care.
Purpose of the Study:
- To develop and validate a reliable instrument for assessing hospital readiness to administer IV tPA within 60 minutes of arrival.
- To provide health systems with a tool to identify specific areas for improving door-to-needle times.
- To support quality improvement initiatives aimed at accelerating stroke treatment.
Main Methods:
- A 67-item Likert-scale survey was administered via telephone to stroke personnel at 252 U.S. hospitals in the 'Get With The Guidelines-Stroke' program.
- Factor analysis was employed to refine the initial survey instrument.
- The refined instrument consists of 29 items across four factors, designed to measure hospital readiness for rapid IV tPA administration.
Main Results:
- A validated 29-item, four-factor instrument was developed to assess hospital readiness for timely IV tPA administration.
- The instrument effectively identifies key areas influencing the door-to-needle time for ischemic stroke patients.
- This tool provides a structured approach for hospitals to evaluate and enhance their stroke treatment protocols.
Conclusions:
- The developed 29-item instrument is a valuable tool for hospitals to assess readiness for administering IV tPA within the critical 60-minute window.
- This assessment tool can guide targeted interventions to reduce door-to-needle times, thereby improving care for ischemic stroke patients.
- Implementation of this instrument supports quality improvement efforts in stroke care delivery nationwide.
