Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators

Anna Alegiani; Michael Rosenkranz; Leonie Schmitz; Susanne Lezius; Günter Seidel; Volker Heßelmann; Rudolf Töpper; Christoph Terborg; Peter P Urban; Roland Brüning; Jan Höltje; Florian Lienau; Christian Arning; Lars Marquardt; Axel Müller-Jensen; Joachim Röther; Bernd Eckert; Antonia Zapf; Jens Fiehler; Götz Thomalla; Christian Gerloff

doi:10.1159/000518428

Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators

Anna Alegiani, Michael Rosenkranz, Leonie Schmitz, Susanne Lezius, Günter Seidel, Volker Heßelmann, Rudolf Töpper, Christoph Terborg, Peter P Urban, Roland Brüning, Jan Höltje, Florian Lienau, Christian Arning, Lars Marquardt, Axel Müller-Jensen, Joachim Röther, Bernd Eckert, Antonia Zapf, Jens Fiehler, Götz ThomallaChristian Gerloff

Abstract

BACKGROUND AND PURPOSE: Rapid access to acute stroke treatment improves clinical outcomes in patients with ischemic stroke. We aimed to shorten the time to admission and to acute stroke treatment for patients with acute stroke in the Hamburg metropolitan area by collaborative multilevel measures involving all hospitals with stroke units, the Emergency Medical Services (EMS), and health-care authorities.

METHODS: In 2007, an area-wide stroke care quality project was initiated. The project included mandatory admission of all stroke patients in Hamburg exclusively to hospitals with stroke units, harmonized acute treatment algorithms among all hospitals, repeated training of the EMS staff, a multimedia educational campaign, and a mandatory stroke care quality monitoring system based on structured data assessment and quality indicators for procedural measures. We analyzed data of all patients with acute stroke who received inhospital treatment in the city of Hamburg during the evaluation period from the quality assurance database data and evaluated trends of key quality indicators over time.

RESULTS: From 2007 to 2016, a total of 83,395 patients with acute stroke were registered. During this period, the proportion of patients admitted within ≤3 h from symptom onset increased over time from 27.8% in 2007 to 35.2% in 2016 (p < 0.001). The proportion of patients who received rapid thrombolysis (within ≤30 min after admission) increased from 7.7 to 54.1% (p < 0.001).

CONCLUSIONS: Collaborative stroke care quality projects are suitable and effective to improve acute stroke care.

Original language	English
Journal	European Neurology
Volume	85
Issue number	1
Pages (from-to)	39-49
Number of pages	11
ISSN	0014-3022
DOIs	https://doi.org/10.1159/000518428
Publication status	Published - 2022

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Alegiani, A., Rosenkranz, M., Schmitz, L., Lezius, S., Seidel, G., Heßelmann, V., Töpper, R., Terborg, C., Urban, P. P., Brüning, R., Höltje, J., Lienau, F., Arning, C., Marquardt, L., Müller-Jensen, A., Röther, J., Eckert, B., Zapf, A., Fiehler, J., ... Gerloff, C. (2022). Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators. European Neurology, 85(1), 39-49. https://doi.org/10.1159/000518428

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title = "Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators",

abstract = "BACKGROUND AND PURPOSE: Rapid access to acute stroke treatment improves clinical outcomes in patients with ischemic stroke. We aimed to shorten the time to admission and to acute stroke treatment for patients with acute stroke in the Hamburg metropolitan area by collaborative multilevel measures involving all hospitals with stroke units, the Emergency Medical Services (EMS), and health-care authorities.METHODS: In 2007, an area-wide stroke care quality project was initiated. The project included mandatory admission of all stroke patients in Hamburg exclusively to hospitals with stroke units, harmonized acute treatment algorithms among all hospitals, repeated training of the EMS staff, a multimedia educational campaign, and a mandatory stroke care quality monitoring system based on structured data assessment and quality indicators for procedural measures. We analyzed data of all patients with acute stroke who received inhospital treatment in the city of Hamburg during the evaluation period from the quality assurance database data and evaluated trends of key quality indicators over time.RESULTS: From 2007 to 2016, a total of 83,395 patients with acute stroke were registered. During this period, the proportion of patients admitted within ≤3 h from symptom onset increased over time from 27.8% in 2007 to 35.2% in 2016 (p < 0.001). The proportion of patients who received rapid thrombolysis (within ≤30 min after admission) increased from 7.7 to 54.1% (p < 0.001).CONCLUSIONS: Collaborative stroke care quality projects are suitable and effective to improve acute stroke care.",

author = "Anna Alegiani and Michael Rosenkranz and Leonie Schmitz and Susanne Lezius and G{\"u}nter Seidel and Volker He{\ss}elmann and Rudolf T{\"o}pper and Christoph Terborg and Urban, {Peter P} and Roland Br{\"u}ning and Jan H{\"o}ltje and Florian Lienau and Christian Arning and Lars Marquardt and Axel M{\"u}ller-Jensen and Joachim R{\"o}ther and Bernd Eckert and Antonia Zapf and Jens Fiehler and G{\"o}tz Thomalla and Christian Gerloff",

note = "{\textcopyright} 2021 S. Karger AG, Basel.",

year = "2022",

doi = "10.1159/000518428",

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pages = "39--49",

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Alegiani, A, Rosenkranz, M, Schmitz, L, Lezius, S, Seidel, G, Heßelmann, V, Töpper, R, Terborg, C, Urban, PP, Brüning, R, Höltje, J, Lienau, F, Arning, C, Marquardt, L, Müller-Jensen, A, Röther, J, Eckert, B, Zapf, A, Fiehler, J, Thomalla, G & Gerloff, C 2022, 'Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators', European Neurology, vol. 85, no. 1, pp. 39-49. https://doi.org/10.1159/000518428

TY - JOUR

T1 - Ten Years of Improving Acute Stroke Management in a Metropolitan Area

T2 - A Population-Based Quantification of Quality Indicators

AU - Alegiani, Anna

AU - Rosenkranz, Michael

AU - Schmitz, Leonie

AU - Lezius, Susanne

AU - Seidel, Günter

AU - Heßelmann, Volker

AU - Töpper, Rudolf

AU - Terborg, Christoph

AU - Urban, Peter P

AU - Brüning, Roland

AU - Höltje, Jan

AU - Lienau, Florian

AU - Arning, Christian

AU - Marquardt, Lars

AU - Müller-Jensen, Axel

AU - Röther, Joachim

AU - Eckert, Bernd

AU - Zapf, Antonia

AU - Fiehler, Jens

AU - Thomalla, Götz

AU - Gerloff, Christian

PY - 2022

Y1 - 2022

N2 - BACKGROUND AND PURPOSE: Rapid access to acute stroke treatment improves clinical outcomes in patients with ischemic stroke. We aimed to shorten the time to admission and to acute stroke treatment for patients with acute stroke in the Hamburg metropolitan area by collaborative multilevel measures involving all hospitals with stroke units, the Emergency Medical Services (EMS), and health-care authorities.METHODS: In 2007, an area-wide stroke care quality project was initiated. The project included mandatory admission of all stroke patients in Hamburg exclusively to hospitals with stroke units, harmonized acute treatment algorithms among all hospitals, repeated training of the EMS staff, a multimedia educational campaign, and a mandatory stroke care quality monitoring system based on structured data assessment and quality indicators for procedural measures. We analyzed data of all patients with acute stroke who received inhospital treatment in the city of Hamburg during the evaluation period from the quality assurance database data and evaluated trends of key quality indicators over time.RESULTS: From 2007 to 2016, a total of 83,395 patients with acute stroke were registered. During this period, the proportion of patients admitted within ≤3 h from symptom onset increased over time from 27.8% in 2007 to 35.2% in 2016 (p < 0.001). The proportion of patients who received rapid thrombolysis (within ≤30 min after admission) increased from 7.7 to 54.1% (p < 0.001).CONCLUSIONS: Collaborative stroke care quality projects are suitable and effective to improve acute stroke care.

AB - BACKGROUND AND PURPOSE: Rapid access to acute stroke treatment improves clinical outcomes in patients with ischemic stroke. We aimed to shorten the time to admission and to acute stroke treatment for patients with acute stroke in the Hamburg metropolitan area by collaborative multilevel measures involving all hospitals with stroke units, the Emergency Medical Services (EMS), and health-care authorities.METHODS: In 2007, an area-wide stroke care quality project was initiated. The project included mandatory admission of all stroke patients in Hamburg exclusively to hospitals with stroke units, harmonized acute treatment algorithms among all hospitals, repeated training of the EMS staff, a multimedia educational campaign, and a mandatory stroke care quality monitoring system based on structured data assessment and quality indicators for procedural measures. We analyzed data of all patients with acute stroke who received inhospital treatment in the city of Hamburg during the evaluation period from the quality assurance database data and evaluated trends of key quality indicators over time.RESULTS: From 2007 to 2016, a total of 83,395 patients with acute stroke were registered. During this period, the proportion of patients admitted within ≤3 h from symptom onset increased over time from 27.8% in 2007 to 35.2% in 2016 (p < 0.001). The proportion of patients who received rapid thrombolysis (within ≤30 min after admission) increased from 7.7 to 54.1% (p < 0.001).CONCLUSIONS: Collaborative stroke care quality projects are suitable and effective to improve acute stroke care.

U2 - 10.1159/000518428

DO - 10.1159/000518428

M3 - Journal articles

C2 - 34818228

SN - 0014-3022

VL - 85

SP - 39

EP - 49

JO - European Neurology

JF - European Neurology

IS - 1

ER -

Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators

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