Title : Improving Stroke Quality Metrics at Robert Packer Hospital
Abstract:
Stroke is the number one preventable cause of disability and a leading cause of death in both men and women; rapid assessment and treatment is critical to improve outcomes for patients. Guthrie Robert Packer Hospital received The Joint Commission Primary Stroke Center certification in 2016, which set the following stroke measurement requirements for care of stroke patients: dysphagia screening, LDL draw and documentation, modified Rankin scale, and NIH Stroke Scale. The mission of this project is to assist Robert Packer Hospital in improving the utilization of the modified Rankin Scale, dysphagia screening, LDL screening, and NIH scale documentation at time of admission, in the management in the treatment of stroke patients. The respective benchmark goals from May 2021 to March 2021 are as follows:
1) Improvement or maintenance of 88.89% for NIH stroke scale documentation at time of admission
2) Improvement or maintenance of 97.22% for LDL documentation
3) Improvement from 83.33% to 91.66% for the modified Rankin Scale
4) Improvement from 69.44% to 76.38 % for dysphagia screening
The team received a daily list of all patients with an ICD-10 code falling under the stroke diagnosis. Starting in December 2021 until Feb 2022, 1 team member per week worked with the hospital stroke team to look over the list daily and check see which patients were not being assessed properly using our 4 measured metrics. This team member also checked to see whether patients were being placed on the hospital designated stroke pathway in EPIC. This EPIC stroke pathway has all quality metrics built in, thus increasing ease of compliance with the metrics. If a patient was not being followed up on one or more measures, the assigned team member would find the appropriate provider and message them securely on EPIC or via Guthrie email in a timely fashion, emphasizing the importance of each quality metric in improving patient outcomes. More patients were placed on the stroke pathway post-intervention, and four out of four measured metrics improved to our goal level post-intervention. Two metrics (NIHSS and LDL documentation) improved to 100%.
What will the audience learn from your presentation?
· Improving modified Rankin Scale, dysphagia screening, LDL screening, and NIH scale documentation may lead to improved patient outcomes
· Proper documentation can prevent errors and ensure each stroke patient receives the appropriate workup
