Quality Measures in Stroke

Stroke is a major public health burden, and accounts for many hospitalizations each year. Due to gaps in practice and recommended guidelines, there has been a recent push toward implementing quality measures to be used for improving patient care, comparing institutions, as well as for rewarding or penalizing physicians through pay-for-performance. This article reviews the major organizations involved in implementing quality metrics for stroke, and the 10 major metrics currently being tracked. We also discuss possible future metrics and the implications of public reporting and using metrics for pay-for-performance.

[1]  R. Edelman,et al.  Evidence-based guideline: The role of diffusion and perfusion MRI for the diagnosis of acute ischemic stroke , 2010, Neurology.

[2]  Eric E. Smith,et al.  Development of Stroke Performance Measures: Definitions, Methods, and Current Measures , 2010, Stroke.

[3]  Michael D Hill,et al.  Stenting versus endarterectomy for treatment of carotid-artery stenosis. , 2010, The New England journal of medicine.

[4]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[5]  M. Lansberg,et al.  Efficacy and Safety of Tissue Plasminogen Activator 3 to 4.5 Hours After Acute Ischemic Stroke: A Metaanalysis , 2009, Stroke.

[6]  P. Sandercock,et al.  Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial , 2009, The Lancet.

[7]  A. Forster,et al.  Cochrane review: information provision for stroke patients and their caregivers , 2009, Clinical rehabilitation.

[8]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. , 2009, Circulation.

[9]  E. DeLong,et al.  ACC/AHA classification of care metrics: performance measures and quality metrics: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. , 2008, Circulation.

[10]  C. Benesch,et al.  Public Reporting of Quality Data for Stroke: Is It Measuring Quality? , 2008, Stroke.

[11]  R. Grol,et al.  Factors That Influence the Stroke Care Team's Effectiveness in Reducing the Length of Hospital Stay , 2008, Stroke.

[12]  P. Kamphuisen,et al.  Venous thromboembolism prophylaxis and treatment in patients with acute stroke and traumatic brain injury , 2008, Current opinion in critical care.

[13]  J. McCue,et al.  Antibiotic timing and errors in diagnosing pneumonia. , 2008, Archives of internal medicine.

[14]  Adnan I. Qureshi,et al.  Guidelines for the Early Management of Adults With Ischemic Stroke , 2007 .

[15]  C. Kase,et al.  The efficacy and safety of enoxaparin versus unfractionated heparin for the prevention of venous thromboembolism after acute ischaemic stroke (PREVAIL Study): an open-label randomised comparison , 2007, The Lancet.

[16]  G. Lenzi,et al.  Monitoring After the Acute Stage of Stroke: A Prospective Study , 2007, Stroke.

[17]  A. Algra,et al.  Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of arterial origin (ESPRIT): a randomised controlled trial , 2007, The Lancet Neurology.

[18]  M. Kanwar,et al.  Misdiagnosis of community-acquired pneumonia and inappropriate utilization of antibiotics: side effects of the 4-h antibiotic administration rule. , 2006, Chest.

[19]  Karen Furie,et al.  Formal Dysphagia Screening Protocols Prevent Pneumonia , 2005, Stroke.

[20]  D. Asch,et al.  The unintended consequences of publicly reporting quality information. , 2005, JAMA.

[21]  J. Saver,et al.  In-Hospital Initiation of Secondary Stroke Prevention Therapies Yields High Rates of Adherence at Follow-up , 2004, Stroke.

[22]  P. Koudstaal,et al.  Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack. , 2004, The Cochrane database of systematic reviews.

[23]  A. Rudd,et al.  Venous Thromboembolism After Acute Ischemic Stroke: A Prospective Study Using Magnetic Resonance Direct Thrombus Imaging , 2004, Stroke.

[24]  A. Forster,et al.  A randomized trial to evaluate an education programme for patients and carers after stroke , 2004, Clinical rehabilitation.

[25]  J. Leonardi-Bee,et al.  Blood Pressure Reduction and Secondary Prevention of Stroke and Other Vascular Events: A Systematic Review , 2003, Stroke.

[26]  P. Langhorne,et al.  Evidence-based stroke rehabilitation. , 2002, Age and ageing.

[27]  Catherine Sudlow,et al.  Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients , 2002, BMJ : British Medical Journal.

[28]  K. Furie,et al.  A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. , 2001, The New England journal of medicine.

[29]  H. Rodgers,et al.  Randomized controlled trial of a comprehensive stroke education program for patients and caregivers. , 1999, Stroke.

[30]  H Rodgers,et al.  Can stroke patients use visual analogue scales? , 1999, Stroke.

[31]  S. Slørdahl,et al.  Treatment in a combined acute and rehabilitation stroke unit: which aspects are most important? , 1999, Stroke.

[32]  R. Ruff,et al.  Pneumatic sequential compression reduces the risk of deep vein thrombosis in stroke patients , 1998, Neurology.

[33]  J. Slattery,et al.  Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST) , 1998, The Lancet.

[34]  J. Scott,et al.  Pulmonary embolism associated with acute stroke. , 1997, Mayo Clinic proceedings.

[35]  Joseph P. Broderick,et al.  Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. , 1995 .

[36]  Eaft Study Group.  Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke , 1993, The Lancet.

[37]  D. Sackett,et al.  Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. , 1991, The New England journal of medicine.

[38]  W Wieners,et al.  On measuring quality. , 1988, Computers in healthcare.

[39]  C. Warlow,et al.  Deep venous thrombosis of the legs after strokes: Part 2-Natural history. , 1976, British medical journal.

[40]  A. Rabinstein.  Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke , 2010 .

[41]  Leandro Provinciali,et al.  Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke , 1993 .