Title

Get with the guidelines award winning hospitals are associated with decreased door to needle times in Michigan and Wisconsin

Aurora Affiliations

Aurora Healthcare

Abstract

Background & Objectives: Stroke is the fifth leading cause of death and the leading cause of disability in the U.S. Timely administration of IV tPA, can lead to reduction in the severity of disability and improved patient outcomes.Previous studies have concluded that for every minute of onset-to-treatment time saved, 1.8 days of healthy life is given to the patient.Get With The Guidelines (GWTG) Stroke is an in-hospital quality improvement initiative designed to improve care by promoting adherence to the latest scientific guidelines.Hospitals participating in GWTG are recognized with achievement awards for high levels of adherence to the evidence based guidelines and target stroke awards for performance related to the Target Stroke initiative, focused on reducing door-to-needle (DTN) time.The objective of the abstract is to examine the association between hospital adherence to GWTG and Target Stroke measures and the impact on DTN times in ischemic stroke patients.

Methods: A retrospective review was conducted of DTN time from 63 hospitals(n=1602) using GWTG Stroke in Wisconsin and Michigan from January 2013-December 2014.Data was divided into GWTG achievement award hospitals, hospitals with a target stroke award, and GWTG hospitals that did not achieve award status.

Results: In 2013, GWTG achievement award winning hospitals demonstrated an average median DTN time of 67 minutes, while target stroke hospitals average median DTN time was 60 minutes.GWTG non-award winning hospitals had an average DTN time of 78 minutes.2014 data indicated achievement award winning hospitals had an average DTN time of 55 min, target Stroke hospitals had an average DTN time of 53 min, and non-award winning hospitals had an average DTN time of 73 minutes.

Conclusions: Hospitals achieving GWTG award recognition status through adherence of evidence based guidelines have a significantly shorter DTN time.Over a two year period, GWTG achievement award winning hospitals had an average median DTN time of 14.5 minutes faster than non-award winning hospitals, resulting in an additional 26.1 days of healthy living for the patient.This translates into significant healthcare cost savings, reduced severity of disability, improved patient outcomes, and additional healthy days of living.

Document Type

Abstract