Outcomes

Measure descriptions and why they are important

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 alteplase was initiated at this hospital within 180 minutes (3 hours) of time last known well. 

Intravenous (IV) thrombolytic therapy is a treatment that dissolves blood clots. When someone is having a stroke caused by a clot in a blood vessel supplying their brain (ischemic stroke), IV thrombolytic therapy can restore blood flow and limit damage to the brain. The sooner it is given to a patient with an ischemic stroke, the better the chances of survival and of recovering without disability. 

Early Antithrombotic prescribed at discharge 

Percent of patients with ischemic stroke or TIA who receive antithrombotic therapy by the end of hospital day two. 

Studies have shown that starting aspirin within 48 hours after a stroke can reduce the risk of dying and can help prevent another stroke. 

VTE prophylaxis 

Percent of patients with an ischemic stroke, or a hemorrhagic stroke, or stroke not otherwise specified who receive VTE prophylaxis the day of or the day after hospital admission. 

Having a stroke increases the risk of developing a blood clot, especially if the stroke is severe or the patient can't move around well. If a clot forms, it could travel through the bloodstream and block a vessel supplying blood to the lungs. If this occurs, it can be life-threatening, so it's very important to start treatment to prevent development of a clot as soon as possible. 

Antithrombotics  

Percent of patients with an ischemic stroke or TIA prescribed antithrombotic therapy at discharge. 

Antithrombotic medications help reduce the formation of potentially dangerous blood clots. Patients who have had a a TIA or a stroke caused by a blood clot should be prescribed an antithrombotic before leaving the hospital to reduce the risk of dying and of having another stroke or TIA. 

Anticoagulation prescribed for AFIB/Aflutter  

Percent of patients with an ischemic stroke or TIA prescribed antithrombotic therapy at discharge. 

For patients who have atrial fibrillation, taking an appropriate anticoagulant (or blood thinner) can reduce the risk of developing a blood clot, which could cause a heart attack or another stroke. If not taking one already, an anticoagulant should be prescribed for patients admitted for an ischemic stroke or TIA who also have atrial fibrillation. 

Smoking cessation  

Percent of patients with ischemic or hemorrhagic stroke, or TIA with a history of smoking cigarettes, who are, or whose caregivers are, given smoking cessation advice or counseling during hospital stay. 

Patients who smoke should be counseled to stop smoking to reduce the risk of another stroke and to promote recovery. Research indicates that patients who receive even brief smoking counseling from their physicians are more likely to quit than those who receive no counseling at all. 

Door to needle (Time to intravenous thrombolytic therapy) – 60 min  

Percent of acute ischemic stroke patients receiving intravenous alteplase therapy during the hospital stay who have a time from hospital arrival to initiation of thrombolytic therapy administration (door-to-needle time) of 60 minutes or less. 

Intravenous (IV) thrombolytic therapy is a treatment that dissolves blood clots. When a patient is having a stroke caused by a clot in a blood vessel supplying their brain (ischemic stroke), IV thrombolytic therapy can restore blood flow and limit damage to the brain. The sooner it is given to a patient with an ischemic stroke, the better the chances of survival and of recovering without disability. 

Statin prescribed at discharge 

Percent of ischemic stroke or TIA patients who are discharged on Statin Medication. 

Research has shown that statin medications can reduce the risk of another ischemic stroke. Patients who are started on a statin while they are still in the hospital may be more likely to continue taking the medication as prescribed when they go home. 

Intensive statin therapy 

Percentage of ischemic stroke and TIA patients who are prescribed high-intensity statin therapy at discharge OR, if older than 75, are prescribed at least moderate-intensity statin therapy at discharge. 

Research has shown that statin medications can reduce the risk of another ischemic stroke. Taking a high-intensity dose of statin provides the most benefit in reducing risk. Patients who are over 75 or who are not able to tolerate a high-intensity dose of statin should be prescribed a moderate-intensity dose. Patients who are started on a statin while they are still in the hospital may be more likely to continue taking the medication as prescribed when they go home.