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Benchmarks and determinants of adherence to stroke performance measures.

Kent DM, Hermann. Benchmarks and determinants of adherence to stroke performance measures. Stroke; A Journal of Cerebral Circulation. 2008 May 1; 39(5):1619-20.

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Abstract:

BACKGROUND AND PURPOSE: Develop achievable benchmarks for 9 stroke performance measures (PM) and to identify organizational factors associated with adherence. METHODS: Adherence rates and achievable benchmarks were determined for 9 PM within a study of patients (n = 2294) admitted with acute ischemic stroke at 17 hospitals. Baseline information regarding hospital characteristics and stroke-specific processes of care were collected, and multi-level models were used to test the association of these factors with adherence. RESULTS: Benchmarks were > or = 90% for 8 of the 9 PM. After controlling for clustering, only use of standing orders was associated with adherence to PM, including: dysphagia screening, venous thrombosis prophylaxis, consideration of tPA, and provision of educational material. CONCLUSIONS: High levels of adherence are achievable for several acute stroke PM. Use of standing orders is associated with adherence to PM requiring immediate action on admission.




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