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Stroke Patient Outcomes. State Hospital Review and Planning Council July 22,2010 Anna Colello . Stroke Designated Hospitals by Region. Outcome Measure – Mortality (Designated vs. Not Designated). Stroke Provider Performance by Provider Type New York State Inpatient Hospitalizations 2008.

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stroke patient outcomes

Stroke Patient Outcomes

State Hospital Review and Planning Council

July 22,2010

Anna Colello

slide6

Stroke Patients

by

Patient Characteristics and Location of Treatment

2008

stroke patient outcome by patient characteristics 2008 discharge disposition
Stroke Patient Outcomeby Patient Characteristics2008Discharge Disposition
the 12 performance measures
The 12 Performance Measures
  • DVT Prophylaxis
  • Early Antithrombotics
  • Anticoagulation for AF
  • IV t-PA 2 Hour
  • Antithrombotics at Discharge
  • LDL > 100 or Not Documented
  • Dysphagia screening
  • Stroke Education
  • Smoking Cessation
  • Rehabilitation Considered
  • NIHSS
  • Discharge Destination
brain imaging in 25mins percent of patients who receive brain imaging within 25 mins of arrival
Brain Imaging in <25minsPercent of patients who receive brain imaging within 25 mins of arrival

*Data from GWTG-Stroke Database

overview of data from 2008 from get with the guidelines stroke sm as of 1 12 10
Overview of Data from 2008 (from Get With The Guidelines-StrokeSM as of 1/12/10)

Nationwide (all hospitals)

N=295,132 patients (1664 hospitals nationwide)

New York State

N=29,426 patients (110 Designated Stroke Centers)

iv tpa cases from get with the guidelines stroke sm as of 1 12 10
IV-tPA Cases (from Get With The Guidelines-StrokeSM as of 1/12/10)

Nationwide (all hospitals)

2008: 7421/11629—63.8%

2009: 8704/12064—72.1%

New York State

2008: 798/1097—72.7%

2009: 875/1122—78%

slide24

IV rt-PA Arrive by 2 Hour, Treat by 3 Hour*Percent of acute ischemic stroke patients who arrive at the hospital within 120 minutes (2 hours) of time last known well and for whom IV t-PA was initiated atthis hospital within 180 minutes (3 hours) of time last known well.

*Data from GWTG-Stroke Database

slide25

IV rt-PA Arrive by 2 Hour, Treat by 3 Hour*Percent of acute ischemic stroke patients who arrive at the hospital within 120 minutes (2 hours) of time last known well and for whom IV t-PA was initiated atthis hospital within 180 minutes (3 hours) of time last known well.

*Data from GWTG-Stroke Database

slide26

Dysphagia Screen*Percent of patients with ischemic, or hemorrhagic stroke who undergo screening for dysphagia with an evidenced-based bedside testing protocol approved bythe hospital before being given any food, fluids, or medication by mouth.

*Data from GWTG-Stroke Database

slide27

Dysphagia Screen*Percent of patients with ischemic, or hemorrhagic stroke who undergo screening for dysphagia with an evidenced-based bedside testing protocol approved bythe hospital before being given any food, fluids, or medication by mouth.

*Data from GWTG-Stroke Database

slide28

NIHSS ReportedPercent of Ischemic stroke, TIA, and Stroke not otherwise specified patients with a score reported for NIH Stroke Scale (Initial)

*Data from GWTG-Stroke Database

slide29

NIHSS ReportedPercent of Ischemic stroke, TIA, and Stroke not otherwise specified patients with a score reported for NIH Stroke Scale (Initial)

*Data from GWTG-Stroke Database

doh accomplishments
DOH Accomplishments
  • Medicaid and tPA
  • Beginning April 1, 2010 Medicaid will reimburse for the administration of tPA in the Emergency Department at a rate more closely aligned with the cost