A stroke occurs when blood flow to the brain is interrupted and brain cells begin to die. The fifth leading cause of death in the United States, a stroke can also cause a loss of the ability to speak, memory problems, or paralysis. It is vital that stroke patients receive the right care at the right time to improve survival and reduce their risk of complications. Below are some of the ways that Partners HealthCare seeks to enhance stroke prevention and care.
Stroke
What are we measuring and why?
Preventing strokes in high-risk populations and treating strokes when they occur are the best way to reduce the morbidity and mortality associated with strokes.
| Stroke: Get With The GuidelinesⓇ/PAA Defect-Free Composite Measure |
| Percent of Ischemic Stroke and TIA Patients that Received IV t-PA Within 60 Minutes of Arrival |
What are we doing to improve?
Each of our hospitals reviews our data on strokes in order to share learnings and enhance hospital-wide quality and outcomes. In addition, our Partners-wide Stroke Leadership Committee meets regularly to discuss and promote best practices and opportunities to improve patient care across our system of hospitals. This group recently has worked to develop a number of tools within our electronic health record to further guide clinicians in providing the most appropriate care for each patient, based on the recommendations of the American Heart Association’s Get With The GuidelinesⓇ (GWTG) program. These tools include order sets and a designated area in the patient’s medical record for critical stroke-related guidelines and insight.
Stroke: Get With The GuidelinesⓇ/PAA Defect-Free Composite Measure
To track care quality and outcomes around stroke care, we rely on the Get With The GuidelinesⓇ measures from the American Heart Association’s collaborative performance improvement program.
How are we doing compared to best practices?
Partners hospitals consistently perform at or better than the Massachusetts average for primary stroke service hospitals.
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Partners HealthCare Data Period: Jul 2017-Jun 2018
Partners HealthCare Source: IQVIA
This Get With The Guidelines® Aggregate Data report was generated using the IQVIA PMT® system. Copy or distribution of the Get With The Guidelines® Aggregate Data is prohibited without the prior written consent of the American Heart Association and IQVIA.
Description of the seven GWTG/PAA Defect-Free measures that make up the composite.
- IV t-PA within Three Hours of Stroke Symptom Onset
This measure looks at the percentage of patients who were treated with IV t-PA within three hours of symptom onset among those who arrive at the hospital within two hours of symptom onset. Studies have found that the sooner patients with an ischemic stroke receive intravenous t-PA, a medication that breaks up blood clots, the greater their functional recovery. - Early Antithrombotic Therapy for Stroke Patients
For many patients who have had an acute ischemic stroke or transient ischemic attack (TIA), treatment with antithrombotic therapy helps prevent blood clots in brain arteries when started early. This measure looks at the percentage of patients with ischemic stroke or TIA who receive antithrombotic therapy by the end of their second day in the hospital. - Therapy to Prevent Blood Clots in Stroke Patients
Stroke patients are at high risk for Venous Thromboembolism (VTE), a potentially life-threatening condition where blood clots develop in the body—either a deep vein thrombosis (DVT) or a clot in the lungs, called a pulmonary embolus (PE). This measure looks at the percentage of patients with stroke who receive VTE-prevention therapy on hospital day one or two. - Antithrombotic Therapy at Discharge for Stroke Patients
Antithrombotic therapy can prevent blood clots from forming in brain arteries, reducing stroke mortality and complications for many patients. This measure looks at the percentage of patients with ischemic stroke or TIA who were discharged from the hospital on antithrombotic therapy. - Anticoagulants for Stroke Patients with Atrial Fibrillation
A common cause of an irregular heart rate, atrial fibrillation is a major risk factor for stroke. Anticoagulant medication is used to prevent the formation of blood clots in the heart of patients with atrial fibrillation. This measure looks at the percentage of patients with ischemic stroke or TIA, who also have atrial fibrillation, that were prescribed anticoagulant medication at hospital discharge. - Cholesterol-Lowering Drugs for Stroke Patients
In patients with ischemic stroke caused by atherosclerosis, statins help to lower levels of the “bad” cholesterol that contributes to stroke risk. This measure looks at the percentage of patients admitted with an ischemic stroke who were prescribed a cholesterol-lowering (statin) medication before their hospital discharge. - Smoking Cessation Counseling for Stroke Patients Who Are Smokers
Smoking greatly increases the risk of stroke and it is vital for patients with stroke to quit smoking. This measure looks at the rate at which patients with stroke or TIA, and who have a history of smoking, are given smoking cessation advice during their hospital stay.
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Partners HealthCare Data Period: October 2016-September 2017, January 2017-December 2017, April 2017-March 2018, July 2017-June 2018
Partners HealthCare Source: IQVIA
This Get With The Guidelines® Aggregate Data report was generated using the IQVIA PMT® system. Copy or distribution of the Get With The Guidelines® Aggregate Data is prohibited without the prior written consent of the American Heart Association and IQVIA.
Description of the seven GWTG/PAA Defect-Free measures that make up the composite.
- IV t-PA within Three Hours of Stroke Symptom Onset
Studies have found that the sooner patients with an ischemic stroke receive intravenous t-PA, a medication that breaks up blood clots, the greater their functional recovery.
This measure looks at the percentage of patients who were treated with IV t-PA within three hours of symptom onset among those who arrive at the hospital within two hours of symptom onset. - Early Antithrombotic Therapy for Stroke Patients
For many patients who have had an acute ischemic stroke or transient ischemic attack (TIA), treatment with antithrombotic therapy helps prevent blood clots in brain arteries when started early. This measure looks at the percentage of patients with ischemic stroke or TIA who receive antithrombotic therapy by the end of their second day in the hospital. - Therapy to Prevent Blood Clots in Stroke Patients
Stroke patients are at high risk for Venous Thromboembolism (VTE), a potentially life-threatening condition where blood clots develop in the body—either a deep vein thrombosis (DVT) or a clot in the lungs, called a pulmonary embolus (PE). This measure looks at the percentage of patients with stroke who receive VTE-prevention therapy on hospital day one or two. - Antithrombotic Therapy at Discharge for Stroke Patients
Antithrombotic therapy can prevent blood clots from forming in brain arteries, reducing stroke mortality and complications for many patients. This measure looks at the percentage of patients with ischemic stroke or transient ischemic attack (TIA) who were discharged from the hospital on antithrombotic therapy. - Anticoagulants for Stroke Patients with Atrial Fibrillation
A common cause of an irregular heart rate, atrial fibrillation is a major risk factor for stroke. Anticoagulant medication is used to prevent the formation of blood clots in the heart of patients with atrial fibrillation. This measure looks at the percentage of patients with ischemic stroke or transient ischemic attack (TIA), who also have atrial fibrillation, that were prescribed anticoagulant medication at hospital discharge. - Cholesterol-Lowering Drugs for Stroke Patients
In patients with ischemic stroke caused by atherosclerosis, statins help to lower levels of the “bad” cholesterol that contributes to stroke risk. This measure looks at the percentage of patients admitted with an ischemic stroke who were prescribed a cholesterol-lowering (statin) medication before their hospital discharge. - Smoking Cessation Counseling for Stroke Patients Who Are Smokers
Smoking greatly increases the risk of stroke and it is vital for patients with stroke to quit smoking. This measure looks at the rate at which patients with stroke or TIA, and who have a history of smoking, are given smoking cessation advice during their hospital stay.
Percent of Ischemic Stroke and TIA Patients that Received IV t-PA Within 60 Minutes of Arrival
Studies have found that the sooner ischemic stroke patients receive a type of medication called IV-tPA, which is used to dissolve blood clots, the greater their chance of returning home and resuming a normal lifestyle. IV t-PA must be given to patients in the first few hours after the start of symptoms and only in patients who meet a strict set of criteria. Therefore, only a small percentage of stroke patients are eligible for this treatment. Among ischemic patients who received t-PA, this measure looks at the percentage who received IV t-PA within 60 minutes of arrival to the hospital.
How are we doing compared to best practices?
The majority of Partners HealthCare hospitals provide IV t-PA to eligible patients within 60 minutes at a rate that is higher than the Massachusetts average.
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*Please note that Brigham and Women's Hospital and Brigham and Women's Faulkner Hospital had a small sample size (10 cases or less) for this data period and their results are not shown.
Measure Details
Partners HealthCare Data Period: July 2017 - June 2018
Partners HealthCare Source: IQVIA
This Get With The Guidelines® Aggregate Data report was generated using the IQVIA PMT® system. Copy or distribution of the Get With The Guidelines® Aggregate Data is prohibited without the prior written consent of the American Heart Association and IQVIA.
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Read more details about this measure.
*Please note that Brigham and Women's Hospital, Brigham and Women's Faulkner Hospital and Newton-Wellesley Hospital had a small sample size (10 cases or less) for some data periods and these results are not shown.
Measure Details
Partners HealthCare Data Period: October 2016-September 2017, January 2017-December 2017, April 2017-March 2018, July 2017-June 2018
Partners HealthCare Source: IQVIA
This Get With The Guidelines® Aggregate Data report was generated using the IQVIA PMT® system. Copy or distribution of the Get With The Guidelines® Aggregate Data is prohibited without the prior written consent of the American Heart Association and IQVIA.
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