Johnson AM, Goldstein LB, Bennett P, O'Brien EC, Rosamond WD; investigators of the Registry of the North Carolina Stroke Care Collaborative.

J Am Heart Assoc. 2014 Apr 10;3(2):e000423.

2014

Hospital

Not applicable

Disease-specific Care

No

To examine differences in changes in the quality of acute stroke care at Joint Commission-certified Primary Stroke Centers (PSCs) versus non-PSCs over time.

Observational Study

This study compared compliance with the Joint Commission's 10 acute stroke care performance measures and defect-free care in Primary Stroke Centers (PSCs) and non-PSCs participating in the Registry of the North Carolina Stroke Care Collaborative from January 2005 through February 2010. It included 29,654 cases presenting at 47 hospitals-10 PSCs, eight preparing for certification, and 29 non-PSCs-representing 43% of North Carolina's non-Veterans Affairs, acute care hospitals

Performance measure compliance increased for all measures for all 3 groups in 2005-2010, with the exception of discharge on antithrombotics, which remained consistently high. Primary Stroke Centers (PSCs) and hospitals preparing for certification had better compliance with all but 2 performance measures compared with non-PSCs (each P<0.01). Defect-free care was delivered most consistently at hospitals preparing for certification (52.8%), followed by PSCs (45.0%) and non-PSCs (21.9%). Between 2005 and 2010, PSCs and hospitals preparing for certification had a higher average annual percent increase in the provision of defect-free care (P=0.01 and 0.04, respectively) compared with non-PSCs.

While room for improvement remains, Primary Stroke Center (PSC) certification is associated with an overall improvement in the quality of stroke care in North Carolina.

2005-2010

http://www.ncbi.nlm.nih.gov/pubmed/24721795

hospitals, stroke certification

Positive