Accessing data to improve outcomes
Resources hold a key to enhancing quality and equitable delivery of stroke care.
Managing stroke outcomes — and knowing how other medical facilities manage them — is critical to the quality of stroke care. Using real-world data and reports from multiple sources near and far can identify gaps in care and help address unmet needs in institutions and their communities.
These sources will be the topic of a session Friday, “Leveraging Real-World Data to Enhance Stroke Outcomes.”
Monique Kilkenny, PhD, MPH, will provide an overview of the International Network for Standardized Population Insights and Real-World Evidence for Stroke, or INSPIRE-STROKE, in her presentation, “Importance of Global Collaboration: An Introduction to the (INSPIRE-STROKE) Initiative.”
Kilkenny said INSPIRE-STROKE brings together the scientific community to monitor care and outcomes following stroke internationally, comparing country-level observational data and outcomes with best-practice standards to ensure findings are reliable and robust.
“INSPIRE-STROKE aims to support routine pooling and reporting of country-level administrative data on these outcomes and to seek further international input and preparation on the standardization of methods,” said Kilkenny, who is head of big data, epidemiology and prevention in the Stroke and Aging Research Group at Monash University School of Clinical Sciences in Melbourne, Australia.
“Standardization is important to be able to compare apples with apples,” she said. “This is crucial for several reasons, including consistency and accuracy, efficiency, scalability and quality control.”
The network, Kilkenny said, will also help researchers compare stroke outcomes among countries to identify best practices, understand disparities, guide policy and resource allocation, improve public health and enhance research and collaboration.
Stroke care providers can also use local data to help improve their patient outcomes. The AHA’s Get With The Guidelines® – Stroke initiative is an in-hospital program for improving stroke care by promoting adherence to the latest scientific treatment guidelines. Since the initiative’s launch in 2003, more than 2,000 hospitals have entered more than 7.5 million patient records into its database, providing a robust resource for hospitals and physicians.
Steven Messe, MD, professor of neurology at the Hospital of the University of Pennsylvania in Philadelphia, will highlight examples of how hospitals and other clinical facilities benefited from Get With The Guidelines in his presentation, “Putting Your Data to Work: How to Utilize Data to Identify Gaps in Stroke Patient Care.”
Messe said the Get With The Guidelines program allows sites to use local data to identify gaps in care quality, including prehospital, in-hospital and systems-of-care issues. The program also provides access to up-to-date research and scientific publications, professional education opportunities such as workshops and webinars, clinical tools and resources, and patient education resources to help physicians optimize patient outcomes.
“This database provides powerful tools and insights into the care of patients,” he said. “This allows clinical sites to work on the issues that are most important to them or to focus on where they have identified concerns.”
One hospital, for example, used the data to identify a discrepancy in how fast it initiated thrombolytic treatment in ischemic stroke patients seen during regular work hours, compared with those seen at night via telemedicine.
“They instituted several practice changes and dramatically improved the time to treatment at night, decreasing the telemedicine door-to-needle times from a median of 48 minutes to 30 minutes,” he said.
Another hospital used Get With The Guidelines data to improve documentation of intracerebral hemorrhage severity, a key component of Comprehensive Stroke Center certification. A third hospital demonstrated that adding a stroke-trained nurse to all coded stroke evaluations led to dramatic improvements in treatment times.
“That included a 41-minute decrease in door-to-needle times with 100% of patients receiving thrombolytic treatment within 45 minutes, compared to 50% prior to the change,” he said.
Three additional presentations will address other data tools and how they are being used to improve stroke outcomes:
- “A Long Road Ahead: Improving Stroke Patient Outcomes Through Health Equity Data Collection,” by Shyam Prabhakaran, MD, MS, chair of neurology at the University of Chicago.
- “Data Linkage to Monitor and Improve Care Processes and Outcomes Following Acute Stroke: Value, Faculty and Methods,” by Matthew Reeves, BVSc, PhD, professor of epidemiology and biostatistics at Michigan State University.
- “Standardizing Population-Based Data Analysis in Canada to Reliably Measure and Compare Stroke Outcomes,” by Amy Y.X. Yu, MD, MSc, associate professor of medicine at the University of Toronto.
