IMPlementation of Best PRactices fOr Acute Stroke Care - Developing and Optimizing Regional Systems of Stroke Care
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Stroke
- Sponsor
- Duke University
- Enrollment
- 21646
- Locations
- 9
- Primary Endpoint
- Change in Time from door to drug as measured by medical record
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The purpose of this program is to develop a regional integrated stroke system that identifies, classifies, and treats patients with acute ischemic stroke more rapidly and effectively with reperfusion therapy.
Detailed Description
The design is based upon the implementation of best practice, that is, based on a comprehensive review of AHA guidelines regarding treatment of acute stroke, ICH (intracranial hemorrhage) and SAH(sub arachnoid hemorrhage). In the second phase, the project will be doing national and international surveys of best practices among comprehensive stroke centers and then combine evidence based guidelines and recommendation as well as expert consensus and guidelines when high level evidence is not available from the published literature. The aim to improve public stroke awareness, stroke symptom recognition within the time benefit window for treatment and calling 9-1-1, EMS transportation, and the proportion and speed of reperfusion therapy (fibrinolytic and in appropriate patients- endovascular treatment) in eligible patients. These improvements in acute stroke care delivery are expected to result in lower mortality, fewer recurrent strokes, and improved long term functional outcomes that we will measure.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adult patients \> 18 years of age who undergo the local acute code stroke process
Exclusion Criteria
- •In house patients with stroke are not included in this data set.
Outcomes
Primary Outcomes
Change in Time from door to drug as measured by medical record
Time Frame: From baseline (Q1, 2017), to Quarter 4 (2020)
The time frame starting from the earliest time that the patient is documented as arriving to the hospital to the beginning time of the administration of the drug (TPA)
Change in Time from Door to Tici 2c/3 flow measured by medical record
Time Frame: From baseline (Q1, 2017), to Quarter 4 (2020)
The time frame starting from the earliest time that the patient is documented as arriving to the hospital to the beginning time of Tici 2c/c flow noted in the vessel
Change in Time from Door to Administration of Reversal Agent as measured by medical record
Time Frame: From baseline (Q1, 2017), to Quarter 4 (2020)
The time frame starting from the earliest time that the patient is documented as arriving to the hospital to the beginning time of the administration of the drug (reversal agent)
Secondary Outcomes
- Change in Number of Deaths from Stroke as measure by medical record(From baseline (Q1, 2017) to Quarter 4 (2020))
- Change in Functional Long Term Outcomes as measured by Modified Rankin Scale(From baseline , 3 months)