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Duke Hospital Receives Get With The Guidelines- Stroke Gold Plus Quality Achievement Award

posted July 18th, 2011

By Katherine Armistead, Intern

Award acknowledges Duke’s commitment to high-quality care for stroke patients

DURHAM, NC, 2011 – Stroke is one of the leading causes of death and serious, longterm disability in the United States.

So, for the patients we serve, Duke’s receipt of the American Heart Association/American Stroke Association’s Get With The Guidelines®- Stroke Gold Plus Quality Achievement Award is external recognition for our internal commitment to our core value of caring for our patients. This national award acknowledges success in implementing excellent care for stroke patients according to evidence-based guidelines.

On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year. The number of acute ischemic stroke patients eligible for treatment is expected to grow over the next decade due to increasing stroke incidence and a large aging population.

With a stroke, time lost is brain lost, and the Get With The Guidelines–Stroke Gold Plus Quality Achievement Award demonstrates Duke’s commitment to being one of the top hospitals in the country for providing aggressive, proven stroke care to patients.

“Obtaining the AHA Gold Plus Award for Stroke comes on the heels of the fourth biannual recertification of Duke Primary Stroke Center by the Joint Commission,” says Larry B. Goldstein, M.D., director of The Stroke Center and professor of medicine (neurology). “Both the recertification by the Joint Commission and the AHA Gold Plus Award are testaments to the world-class multidisciplinary care provided to our patients who have had a stroke — from the Emergency Department; through the neurosciences inpatient units, including the Stroke Unit; Neurosciences ICU and Intermediate Care units and involving providers from Nursing; the ED; Neurology; Radiology; Neurosurgery; Vascular Surgery; Physical Therapy; Occupational Therapy; Speech and Language Pathology; Dietary Services; Pharmacy - among many others. All our patients receive the best possible, state-of-the-art, evidence-based care,” says Goldstein, proving that “It Takes a Team” to care for stroke patients.

To receive award recognition, Duke achieved 85 percent or higher adherence to all Get With The Guidelines-Stroke Quality Achievement indicators for two or more consecutive 12-month intervals and achieved 75 percent or higher compliance with six of 10 Get With The Guidelines-Stroke Quality Measures, which are reporting initiatives to measure quality of care.

These measures include aggressive use of medications, such as tPA, antithrombotics, anticoagulation therapy, DVT prophylaxis, cholesterol reducing drugs and smoking cessation, all aimed at reducing death and disability and improving the lives of stroke patients.

“Duke is to be commended for its commitment to implementing standards of care and protocols for treating stroke patients,” said Lee H. Schwamm, M.D., chair of the Get With The Guidelines National Steering Committee and director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital in Boston. “The full implementation of acute care and secondary prevention recommendations and guidelines is a critical step in saving the lives and improving outcomes of stroke patients.”

The Duke Stroke Center is also one of three nationally recognized American Stroke Association–Bugher Foundation Centers for Stroke Prevention Research. In demonstration of their commitment to the organizational value of excellence, the team continues to explore opportunities to improve provision of immediate care to stroke patients. Their next goal: achievement of the Target: Stroke Honor Roll. This focuses on acute ischemic stroke treatment with intravenous thrombolysis in 60 minutes or less. This is a difficult measure to attain as there is great deal of information to collect in that 60-minute window to decide whether the patient is eligible for thrombolytic therapy.

Achieving the Target: Stroke Honor Roll will involve “intricate planning from a highly organized stroke team response and rapid work-up to make the decision to treat,” says Mark Constable, RN, B.S.N., Stroke Center Program Coordinator.