Abstract T P334: Statewide Collaborative for North Dakota Stroke Care

Abstract

Introduction: The leading causes of death in North Dakota (ND) are heart disease, stroke and cancer. According to the Center for Disease Control and Prevention, stroke accounted for 507 (8%) of the deaths. The ND healthcare system includes 53 counties, 36 critical access hospitals, 6 tertiary hospitals and 108 licensed ground ambulance services serving 723,393 individuals across 70,762 miles. Hypothesis: Improved efficiencies and patient outcomes related to acute stroke care through increased pre-notification by EMS, improved CT timing, and improved Last Known Well (LKW) to arrival times based on scientific guidelines across the continuum of the ND Stroke System of Care. Method: Measurement through data analysis from the Get With the Guidelines ® Patient Management Tool following toolkit dissemination and education completion. Results: A benchmarking group of North Dakota facilities was created through the Get With The Guidelines-Stroke Patient Management Tool. Baseline data showed a LKW to arrival greater than 2 hours at 71% (429/606), CT in less than 25 minutes at 26% (102/392), and 61% (155/254) with EMS pre-notification. The Participating Hospital Advisory Council, comprised of stroke coordinators throughout ND developed a Stroke Toolkit based on current guidelines for healthcare providers and the general public. The toolkit includes: 1) Treatment and Transfer Guidelines, 2) Stroke Education Modules, and 3) Feedback Reports. The education modules address: 1) Basics of Stroke, 2) Stroke Awareness and the EMS Provider, 3) Neuro Assessment/Checks, 4) Inclusion/Exclusion Criteria for Thrombolytic (tPA) Therapy, 5) Care of the Hospitalized Patient with Ischemic Stroke. The toolkit was approved by the ND State System of Care Taskforce and published through the ND Department of Health. Modules are recorded for widespread availability. The Stroke Toolkit will be disseminated throughout the state. Each tertiary stroke coordinator will provide on-site education to their specific regional referral hospitals. Conclusion: Data collected using Get With the Guidelines ® Patient Management Tool in ND demonstrated a need for stroke education and intervention at all levels. The stroke toolkit will address this need.