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

Acute stroke care involves complex decisions that may limit patient understanding in care decisions. Review of National Research Corporation (NRC) patient experience survey data at a Comprehensive Stroke Center identified that patient-perceived participation in care decisions was the least scoring domain, prompting a targeted quality improvement intervention. The primary objective was to evaluate whether by introducing a standardized patient information tool, combined with physician reinforcement, improves patient-perceived participation in care decisions for hospitalized stroke patients. A single-center, pre-post quality improvement study was conducted within the inpatient stroke service using a standardized patient information tool and physician education as a combined intervention. Stroke coordinators reviewed the form with the patient and, when necessary, family members. Interrupted time series analysis was used to evaluate changes in patient-perceived participation, based on monthly NRC response scores from September 2024 through December 2025. Interrupted time series analysis showed no statistically significant change in NRC scores associated with the intervention (p = 0.063). The observed differences in pre-intervention versus post-intervention mean NRC scores (62.1% vs, 91.7%) were largely explained by pre-existing fluctuations and a rising pre-intervention trend. Standardized patient education combined with physician engagement did not produce a statistically significant result when analyzed using interrupted time series analysis. While post-intervention slope suggested improved trend, this finding was not statistically significant after controlling for pre-existing trends and monthly variability. However, the wide confidence intervals and limited post-intervention period imply that a modest effect cannot be ruled out. Larger, long-term studies are needed to confirm these findings.