Abstract WMP28: Developing a New Hospital Into a Primary Stroke Center in Just Over a Year

Abstract

Background: Stroke programs are often developed and implemented in well-established health care facilities. There is little data on certified stroke programs being established in new hospitals. Our primary goal was to establish a strong culture of engagement in the care of stroke patients from the day the hospital opened. Methods: A multidisciplinary stroke oversight committee was formed, which guided development of the stroke program and integrated leaders from all areas involved with direct or indirect stroke patient care. We began trending processes and overall stroke care based on the Get with the Guidelines (GWTG) STK measures. In this study we compared data from the opening of a 160-bed hospital until achieving Primary Stroke Center (PSC) certification (October 2021 - February 2023) to after certification (March 2023 - June 2023). Our primary outcome was to examine the proportion of IV thrombolysis prior to and after PSC certification. Secondary outcomes included: proportion of door-to-needle time within 60 minutes, proportion of EMS arrival and proportion of patients transferred prior to and after PSC certification. Primary and secondary outcomes were analyzed using backwards Wald binomial logistic regression models which were adjusted for age, sex and NIHSS. Results: Among 300 patients evaluated for potential stroke symptoms, 228 (76%) were assessed prior to PSC and 72 (24%) after. Mean age was 63.15±17.37 years and median [IQR] NIHSS was 1 [0, 2]. GWTG STK measures were achieved (> 85%) both before and after PSC certification. There was a higher proportion of patients treated with IV thrombolysis after PSC compared to before (9.7% versus 2.6%), adjusted Odds Ratio (aOR) = 3.66 [95% Confidence Interval (CI), 1.17 - 11.43], p = .026. There was no statistical difference in the proportion of IV thrombolysis patients treated within 60 minutes of arrival after versus before PSC, (57% versus 20%), aOR = 5.33 [95%CI, 0.38 - 75.78], p = 0.22. Additionally, there were similar proportions of EMS arrival and transfers after compared to before PSC, all p > .05. Conclusions: A successful stroke program can be implemented in a new hospital within a short duration of time.