A Quality Improvement Study on Patient-Perceived Participation in Care Decisions at a Comprehensive Stroke Center...

Area of Science:

• Neurology
• Healthcare Quality Improvement
• Patient Experience Research

Background:

• Acute stroke care presents complex decisions impacting patient comprehension.
• Patient-perceived participation in care decisions was identified as a low-scoring domain in stroke patient experience surveys.
• A quality improvement initiative was launched to address this gap.

Purpose of the Study:

• To evaluate if a standardized patient information tool, coupled with physician reinforcement, enhances patient-perceived participation in care decisions for hospitalized stroke patients.
• To assess the impact of a combined intervention on patient engagement in acute stroke care.

Main Methods:

• A single-center, pre-post quality improvement study design was employed.
• The intervention involved a standardized patient information tool reviewed by stroke coordinators and physician education.
• Interrupted time series analysis of National Research Corporation (NRC) patient experience survey scores (September 2024 - December 2025) was used.

Main Results:

• Interrupted time series analysis revealed no statistically significant change in NRC scores post-intervention (p = 0.063).
• Observed pre- to post-intervention score increases (62.1% to 91.7%) were attributed to pre-existing trends and fluctuations.
• The intervention's trend improvement was not statistically significant after controlling for confounding factors.

Conclusions:

• Standardized patient education and physician engagement did not yield a statistically significant improvement in patient-perceived participation in stroke care decisions.
• While a modest effect cannot be definitively ruled out due to wide confidence intervals and a limited post-intervention period, larger, long-term studies are warranted.
• The findings highlight the complexity of improving patient engagement in acute care settings.