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Improving In-Hospital Stroke Response: A Team-based Quality Improvement Program

A National Stroke Association Pilot Program

In-Hospital Stroke Facts

  • Mortality is two to three times higher for in-hospital strokes.
  • Studies consistently demonstrate greater in-hospital delays on evaluation for stroke with onset in the hospital; only 15 percent of in-hospital strokes are evaluated by a physician within 3 hours of symptoms.
  • In-hospital stroke patients are half as likely to return home.

The Program
National Stroke Association has selected seven Stroke Center Network™ member hospitals to participate in the 18-month pilot program that includes a multi-tiered approach to educating hospital staff on the issues surrounding in-hospital stroke.

The program aims to improve hospital processes, reduce time-to-treatment and improve patient outcomes for in-hospital stroke. Despite the availability of on-site hospital resources, it’s been reported that between 4 and 17 percent (31,000 to 134,000) of strokes each year occur in patients who are already in the hospital for other reasons.

Additionally, researchers have found that times-to-treatment for in-hospital strokes can be significantly longer compared with strokes that occur outside of the hospital. Unfortunately, patient morbidity and mortality are also worse for in-hospital strokes.

Through multiple accredited educational tactics, including grand rounds, Lunch-n-Learn’s and Web resources, the program will provide hospital teams with strategies, tools and support to improve patient care and raise awareness of in-hospital stroke.

Program Components
National Stroke Association is taking a multi-tiered approach to educating hospital staff on the issues surrounding in-hospital stroke:

Optimizing Our Response to In-Hospital Stroke Grand Rounds
This grand rounds series, developed by experts Ethan Cumbler, MD, and Soojin Park, MD, takes a case-based approach in educating hospital staff on the impact of in-hospital stroke, the causes of and where in the hospital they most likely occur and current treatment options.
Non-medical Staff Lunch-n-Learn Activities
Stroke center staff can educate the entire hospital staff on the signs and symptoms of stroke and what protocols the hospital has in place when signaling a stroke alert.
Improving In-Hospital Stroke through QI Interventions Webinar
Learn how quality processes have improved in-hospital stroke care metrics and about successful intervention models, tools, and processes that they can apply in their respective situations.
In-Hospital Stroke Resource Center
Access recent peer-reviewed articles, presentations and tools hospitals can use to enhance their own quality improvement project.
Peer coaching
Allows participating pilot sites the opportunity to learn from colleagues nationwide about successes and challenges in conducting the quality improvement project.

The educational program is sponsored by an educational grant from Genentech, Inc. and support from Penumbra, Inc.

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Stroke and You

National Stroke Association

9707 E. Easter Lane, Suite B
Centennial, CO 80112