Better patient outcome linked to
Get With The Guidelines-Stroke
troke patients at hospitals participating in a
nationwide quality-improvement program were
more likely to be discharged home and less
likely to die after discharge than patients in
non-participating hospitals, according to research
in the American Heart Association’s journal Stroke.
The program, Get With The Guidelines®-Stroke,
established by the American Heart Association/American
Stroke Association in 2003, helps hospitals provide stroke
patients with the latest, most effective treatment for stroke.
More than 1,600 hospitals have registered to receive patient-management toolkits, access to workshops, decision support
and many other resources.
“We know that in the past the Get With The Guidelines-
Stroke program was associated with improved processes
of care, such as appropriate medications and other
M.D., M.P.H., lead author of the study and an assistant
professor in neurology at Rush University Medical Center
in Chicago, IL. “Now we know that this
improved care translates into improved
In this study, stroke patients who
received treatment at hospitals participating
in the Get With The Guidelines®-Stroke
program were 10 percent more likely
than those in non-participating hospitals
to be discharged home, rather than to
a rehabilitation center or other facility.
Furthermore, 30 days and one year after
discharge, patients from participating
hospitals were 7 percent to 8 percent less
likely to have died. These findings mean
that in this study alone, participating
hospitals discharged about 1,000 more
stroke patients home than non-participating
hospitals, and about 2,900 fewer patients
died within one year.
“By improving the infrastructure for stroke care, the
program has been effective, not only in improving measures
of process and care, but also clinical outcomes, which is
what patients should care about most,” Song said.
The study consisted of 173,985 Medicare patients with
stroke caused by a blocked blood vessel. Roughly half of
participants received treatment at hospitals participating
in Get With The Guidelines®-Stroke, while the other half
was treated at non-participating hospitals. Participants’
average age was 79 years, three-fifths were women, and
most were white.
Investigators analyzed data from the Centers for Medicare
& Medicaid Service for 366 hospitals participating in Get
With The Guidelines®-Stroke and 366 non-participating
hospitals. The study ran from April 1, 2003 to December 1,
2008, data collection began 18 months before participating
hospitals’ joined the program, and follow-up was up to 18
months after program implementation.
A study limitation is that unforeseen factors could
have affected the results, although investigators did match
patients and hospitals in terms of their characteristics. In
addition, the study did not measure disability after hospital
discharge and could not control for whether or not patients
followed treatment recommendations after leaving the
hospital. This study was also done only in the Medicare
population, so only in people aged 65 or older.
Source: American Heart Association News