Abstract WP383: Disseminating Acute Stroke Feedback to Emergency Care Providers

Abstract

Introduction: Emergency department (ED) clinicians find that feedback on acute stroke patients is rewarding, valuable to professional development, and critical to practice improvement. However, feedback is rarely provided despite the effectiveness of this practice in changing behavior. We sought to evaluate the feasibility and usability of an electronic stroke outcome reporting tool to provide feedback to ED personnel. Methods: We conducted an IRB-approved pilot study in May 2018 at 3 Nashville hospitals. ED staff signed up to receive de-identified reports of clinical (e.g., survival) and operational (e.g., time-to-tPA) outcomes of patients with acute ischemic stroke. Reports were electronically transmitted 72 hours after ED arrival. Providers were surveyed on usefulness of these reports and likelihood to change, and could claim continuing medical education (CME). Descriptive statistics were used to describe survey results. Results: We enrolled 232 ED personnel; 107 (46%) nurses, 57 (25%) attending physicians, 26 (11%) resident physicians, 15 (7%) EMS providers, and 27 (12%) other staff. CME was initiated or claimed by 22 staff. During the study, outcome reports ( Figure ) were transmitted for 56 patients with acute ischemic stroke. There was a mean of 6.0 (SD 2.0) staff/case and 4.1 (SD 1.5) were registered. Reports were viewed by a mean of 2.6 (SD 1.5) registered staff. 97.1% found the reports useful and 36.2% reported likeliness to change practice. On a scale of 1-to-100, nurses rated the reports as most useful (81.9, SD 15), followed by ED residents (77.7, SD 14.7), then ED attendings (73.0, SD 16.8). Conclusions: Electronic reporting of stroke outcomes was feasible, efficient, and useful. Limitations to widespread use include the time required to produce reports which may be addressed through electronic data pulls. Future research should address the effectiveness of this reporting tool as a source of useful provider education.