Abstract TP110: Strengthening Neurology and Cardiology Care Collaboration: Getting to the Heart of Stroke Initiative

Abstract

Introduction: The American Heart Association (AHA) estimates 1 in 3 acute ischemic strokes (AIS) are cryptogenic and approximately 1 in 4 survivors will have another event. Identifying the AIS etiology will help define appropriate therapy and lower the likelihood of having another stroke. Over 67% of Black Americans have at least 1 risk factor for AIS and a higher morbidity & mortality compared to any other racial group. To address these gaps, the AHA launched Getting To The Heart Of Stroke in 2022, in conjunction with HCA Healthcare and HCA Healthcare Foundation, to improve the identification of stroke etiology by strengthening neurology & cardiology care collaboration. An overarching goal of this initiative is to improve healthcare disparities by assuring correct data collection of socioeconomic data, assessing barriers to care and addressing social determinants of health. Methods: Using a learning collaborative model, 10 HCA Comprehensive Stroke Centers, along with their clinical and administrative leadership were engaged. Monthly virtual performance improvement consultations are held to discuss actions taken, identify trends between sites, and develop PDSAs (Plan-Do-Study-Act). Their clinical multidisciplinary teams defined custom and existing metrics using Get With The Guidelines®-Stroke to measure the impact of best practice implementation. Results: Gaps include inconsistent identification of stroke etiology, lack of race documentation and lack of standardized social needs assessments. Barriers include a lack of standard triggers for cardiology and neurology consults on cryptogenic stroke and widely variable documentation by hospital. Sites are creating communication points between departments utilizing a multidisciplinary committee of stroke and cardiology team members. Conclusion: Early data suggest the need to establish standardized processes for the identification of cryptogenic stroke. A framework is necessary to build the foundational relationship between neurology & cardiology to positively impact cryptogenic stroke patient care. Over the next 2 years, the initiative will continue to explore an enhanced framework to identify cryptogenic stroke, optimize secondary prevention strategies, and ensure equitable care.