Special Note: Many WHA members proud of their quality improvement efforts had prepared special poster presentations that were to be displayed in the Capitol Rotunda during WHA’s Advocacy Day 2020, which was cancelled due to the COVID-19 pandemic. WHA is pleased to highlight these efforts in today’s and future editions of The Valued Voice.
The Centers for Disease Control and Prevention (CDC) has funded stroke quality improvement (QI) initiatives since 2001, providing competitive grants to state health departments to support the development of stroke systems of care. This funding is called the Paul Coverdell National Acute Stroke Prevention Program, named after Georgia Senator Paul Coverdell, who suffered and died of a stroke while serving in Congress.
In 2012, Wisconsin was selected to receive funding for three years, and selected again in 2015 for an additional six years. The focus is to demonstrate improvement across stroke systems of care – from emergency medical services (EMS) response to inpatient care, secondary prevention, and post‐stroke rehabilitation. The program works with EMS, hospitals and health systems to link and monitor patient‐level data across the continuum of care.
“WHA has been a founding partner of the Wisconsin Stroke Coalition, whose goal is to improve stroke care and recovery for every citizen of Wisconsin,” WHA Chief Quality Officer Beth Dibbert said. “The CDC’s Coverdell Program funding has allowed stakeholders from clinical, regulatory, advocacy and patient groups to share and promote best-practice care in communities, hospitals and post-acute settings. WHA thanks the Wisconsin Department of Health Services for dedicating resources to this poster presentation that shows results we can all be proud of.”
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Wisconsin Coverdell Stroke Program (WI Coverdell) facilitates the Coverdell Learning Collaborative (CLC) which meets quarterly and is comprised of stroke coordinators from participating WI Coverdell hospitals. The meeting provides WI Coverdell hospitals the opportunity to network with fellow stroke coordinators, ask questions and share best practices. The meeting consists of updating members on stroke systems of care development, recruitment, outreach and QI initiatives.
The CLC began reviewing blinded data from the Get With The Guidelines® stroke registry in Q4 2015 to identify areas where stroke care could be improved. It noted a decrease in the EMS pre-notification measure in Q3 2016. CLC began in-depth discussions and review of the possible issues causing this decrease such as: what are the barriers in successfully capturing the EMS pre-arrival report in the emergency department as well as ease of finding and abstracting the needed information from the electronic health record.
In further data analysis we found our implemented actions to be successful. Not only did EMS pre-notification raise, but the median “door-to-needle” time for those arriving by EMS decreased and stroke treatment with thrombolytics and/or thrombectomy increased.