Standardized guidelines improve outcomes in stroke care

Patients suffering from a stroke are more likely to have improved outcomes and fewer complications when hospitals use standardized guidelines for stroke care during a patient's admission and discharge from the hospital, according to a study led by researchers at UCSF Medical Center. The study results appear in the August 9 issue of Neurology.

"There are several treatments for the most common form of stroke, which is ischemic stroke, and these have been proven to reduce disability and complications," said lead author S. Claiborne Johnston, MD, PhD, director of the stroke service at UCSF Medical Center. "Yet in spite of these recommendations, the interventions are often under-utilized at hospitals."

In an effort to increase the use of these treatments, UCSF Medical Center and five other hospitals in California collaborated to create standardized stroke care guidelines. The guidelines include a list of recommended therapies at the time of hospital admission and discharge, as well as a hand-out with key follow-up information when the patient leaves the hospital. The hand-out is specific for each patient and is designed as a document for the patient to provide at the first doctor visit after discharge. It includes information on discharge diagnosis, discharge medications received (including dosage and frequency), life style changes to reduce risk factors for a second stroke, and directives for follow-up labs and appointments.

The researchers compared treatment before and after implementation of the standardized guidelines, tracking six specific interventions associated with quality stroke care. The interventions are administration of the anticlotting drug tPA (tissue plasminogen activator) within three hours of the onset of stroke symptoms, receipt of additional anticlotting medications within 48 hours of arrival in the emergency department, documentation of preventive treatment for DVT (deep venous thrombosis, or blood clots in the l

Contact: Vanessa deGier
University of California - San Francisco

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