Benchmarks and Determinants of Adherence to Stroke Performance Measures

Abstract

Background and Purpose— Develop achievable benchmarks for 9 stroke performance measures (PM) and to identify organizational factors associated with adherence. Methods— Adherence rates and achievable benchmarks were determined for 9 PM within a study of patients (n=2294) admitted with acute ischemic stroke at 17 hospitals. Baseline information regarding hospital characteristics and stroke-specific processes of care were collected, and multi-level models were used to test the association of these factors with adherence. Results— Benchmarks were ≥90% for 8 of the 9 PM. After controlling for clustering, only use of standing orders was associated with adherence to PM, including: dysphagia screening, venous thrombosis prophylaxis, consideration of tPA, and provision of educational material. Conclusion— High levels of adherence are achievable for several acute stroke PM. Use of standing orders is associated with adherence to PM requiring immediate action on admission.