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Improvements in Emergency Stroke Care: Achievement of ASA Re-Certification
Gay Calo RN, Leanne Wood RN
Introduction/Problem
Prior to 2016, BID-Needham a Gold certification with the American Stroke Association (ASA) as well as
Get with the Guidelines (GWTG) recognition. In 2016, BID-N focused on other aspects of stroke
management which resulted in other stroke measure improvements but unfortunately a lower score for
t-PA administration and therefore the loss of our GWTG recognition.
In 2016 we assessed the program and planned specific interventions to improve the overall program
measures. Knowing that if these improvement methods were successful, it would take at least two years
to regain a Gold certification.
Some of the challenges for this project included the small size of BID-N as a community hospital, and the
resulting small number of patients entering the Emergency Department (ED) for evaluation and treatment
for stroke. Because of our small size and small volume of patients, it presented a challenge for nursing
staff to be educated and re-educated relative to stroke care measures and documentation. This factor
played a significant role in the identification of interventions that would not only educate nurses but also
sustain that knowledge regardless of the patient volume over time.
The Interventions
Education of Nursing Staff:
–
Education re all evidence based best practices for emergency stroke care
•
Focus on Door to Needle times for t-PA
•
Simulations for stroke management in the ED
•
Practice mixing and administering t-PA
•
Created visuals for nursing reference in the ED
Education of MD staff regarding elements of required documentation
–
Results/Progress to Date
Goal Achievement: Time to t-PA
Implement PI
Interventions
100
Aim/Goal
90
Goal
85
%Achievement
Goals:
• Improve nursing knowledge and MD documentation re: early stroke management in the ED
• Improve all measures of success regarding stroke care in the ED
• Regain GWTG certification
95
80
75
70
65
The Team
Anna Murphy RN, ED stroke coordinator
Gay Calo RN, Quality and Safety stroke coordinator
Peter Smulowitz MD, ED Chair
Leanne Wood RN, Nursing Director ED
Margot Geffroy MD, Chair of Neurology
Gregory McSweeney MD, CMO for BID-N
60
55
50
Time to tPA
2016
71
2017
100
2018
100
In 2016, prior to interventions, BID-N Time to t-PA achievement score fell to 71%, losing certification
After interventions, in 2017, Time to t-PA at 100%, regaining certification at silver level;
Sustained in 2018 at 100%- achieving gold certification and designation as a Target Honor Roll Hospital
For more information, contact:
Gay Calo RN, Q&S Stroke Coordinator gcalo@bidneedham.org
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Silverman Symposium
Description
An account of the resource
Each year the Silverman Symposium poster session offers BIDMC staff and affiliates the opportunity to share experiences and learn about efforts to improve Quality and Safety.
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Silverman Poster
Primary Contact
If you would like more information about this project, contact this person. Make email address clickable.
<p>Gay Calo (<a href="mailto:gcalo@bidneedham.org" target="_blank" rel="noreferrer noopener">gcalo@bidneedham.org</a>)</p>
Department
Any departments listed on the poster or identified in the spreadsheet.
Healthcare Quality and Safety
Stroke Team
Neurology
Emergency Department
Nursing
Medicine
BIDMC Location
The BIDMC location where the poster team resides if identified in spreadsheet. If not identified, choose BIDMC.
BID-Needham
Project Team
Anna Murphy
Gay Calo
Peter Smulowitz
Leanne Wood
Margot Geffroy
Gregory McSweeney
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Improvements in Emergency Stroke Care: Achievement of ASA Re-Certification
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Format
The file format, physical medium, or dimensions of the resource
pdf
Compliance
Effectiveness
Efficiency
Safety
Timeliness