New research published in the Journal of the American Heart Association suggests hospital staff perception of how well they treat stroke patients may not match up with the actual stroke care performance, according to a news release from the American Heart Association.
Hospital performance was based on “door-to-needle” time, a measure of how quickly the the intravenous drug known as tissue plasminogen activator (tPA) is administered from the time a patient arrives at the hospital. Guidelines recommend delivering tPA within 60 minutes of the patient’s arrival to the hospital because the drug is proven to reduce both the short- and long-term effects of a stroke, according to the association’s news release.
Other patient measures included the onset of patient stroke symptoms, hospital arrival time, treatments, initiation of tPA, and complications from the drug. These data were compared with hospital staff survey responses. Hospitals were categorized as high-, middle- or low-performing based on the percentage of time they appropriately administered tPA, the release explains.
The research team led by Cheryl Lin, MD, described in the release as a former researcher at Duke Clinical Research Institute in Durham, NC, surveyed staff in 141 hospitals who treated 48,201 stroke patients in 2009 and 2010. The surveyed hospitals all participated in the American Heart Association’s Get With the Guidelines — Stroke national quality improvement program designed to ensure consistency in timely stroke care.
The researchers found that only 29% of hospital staff accurately identified their door-to-needle performance, 42% of middle-performing hospitals and 85% of low-performing hospitals overestimated their abilities to quickly administer tPA, and nearly 20% of low-performing hospitals believed their door-to-needle time was above the national average.
Hospitals that overestimated their performance had lower volumes of tPA administration, the release notes.
Stroke patient volume was one of the factors that affected the disparity between hospital perception and performance. However, hospital size or region did not appear to be a major factor, per the release.
“Institutions at any performance level could benefit from making protocol changes that would better align performance with perception,” Lin says in the release.
“This would have a significant impact on the quality of stroke care delivered across the US,” she continues.
[Source(s): American Heart Association, EurekAlert]