Abstract WP189: Application of a Continuous Quality Improvement Framework: Longitudinal Results From Year 1 of the Stroke Survivor to Survivor Program

Abstract

In 2018, the Mission Lifeline North Dakota (ND) initiative adopted and began to implement Stroke Survivors Empowering Each Other, Inc.’s (SSEEO’s) Stroke Survivor to Survivor (SS2S) program. The SS2S program is a post-stroke support program that aims to facilitate survivors’ efforts to recover after stroke. Volunteers, who are themselves survivors, call participants monthly at least twice following discharge from the hospital and provide them with stroke-related resources and support. The adaptation and implementation of the Chicago-borne SS2S program in ND was embedded within a continuous quality improvement framework to ensure ongoing performance monitoring data could inform programmatic improvements as needed. Key questions: • How has the Chicago-borne SS2S program been adapted to fit the unique characteristics and environment of ND, while maintaining fidelity? • What are performance monitoring findings from the first three quarters of implementation? Between Oct 2018- Feb 2019, four of the six ND tertiary hospitals implemented the SS2S program. These hospitals provide monthly quantitative and qualitative data on program implementation. From Oct 2018 to May 2019, SS2S volunteers made 153 calls to survivors, with 57% (n = 87 of 153) of calls answered by a prospect, including stroke survivors (n=74) and their caregivers (n=13). Thirteen percent (n = 9 of 69) of stroke survivors calls required additional follow-up by hospital staff. SS2S volunteers mailed additional resources to stroke survivors for 48% percent of the calls where the prospect was reached (n= 33 of 69). Seventy percent (n = 48 of 69) of survivors reached were able to identify at least one sign of stroke. Preliminary results suggest that both volunteers and stroke survivors may benefit from the program. Importantly, performance monitoring data also identified opportunities for programmatic improvements. For example, these data informed edits to the volunteers’ phone scripts to clarify signs-of-stroke patient-education. Ongoing feedback from the hospitals have also informed improvements to the performance monitoring processes.