Many Hospitals Overestimate Their Adherence to Stroke Guidelines

Study shows delivery of clot-busting drug is often later than staff believes

By Robert Preidt

Wednesday, July 22, 2015

WEDNESDAY, July 22, 2015 (HealthDay News) -- Many U.S. hospitals overestimate their ability to provide fast delivery of a clot-busting drug to stroke patients, a new study finds.

The drug, called tissue plasminogen activator (tPA), has been shown to reduce the short- and long-term effects of stroke. It should be given to ischemic stroke patients within 60 minutes of their arrival at the hospital, according to guidelines.

An ischemic stroke is caused by blocked blood flow to the brain.

Researchers surveyed staff in 141 hospitals across the United States who treated more than 48,000 stroke patients in 2009 and 2010, and compared their responses with patient data. The results revealed significant differences between staff perception and reality.

Only 29 percent of staff correctly estimated how long it took stroke patients at their hospital to receive tPA, according to the study published July 22 in the Journal of the American Heart Association.

Hospitals were ranked as high-, middle- or low-performing based on the percentage of cases where stroke patients received tPA within the recommended time. Eighty-five percent of low-performing hospitals and 42 percent of middle-performing hospitals overestimated their abilities to quickly administer tPA.

Nearly one in five low-performing hospitals believed the time it took them to administer treatment was better than the national average. The study also found that hospitals that overestimated their performance gave tPA less often than other hospitals.

The number of stroke patients treated at a hospital was a major factor in whether hospitals overestimated their performance in providing appropriate treatment. Hospital size or region did not appear to be significant factors.

Hospitals in the study participated in the American Heart Association's "Get With the Guidelines: Stroke" program, which aims to improve stroke care.

"Institutions at any performance level could benefit from making protocol changes that would better align performance with perception," study lead author Dr. Cheryl Lin, a former researcher at Duke Clinical Research Institute in Durham, N.C., said in a journal news release.

"This would have a significant impact on the quality of stroke care delivered across the U.S.," she added.

SOURCE: Journal of the American Heart Association, news release, July 22, 2015

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