Quality of Stroke Care Among Ischemic Stroke Patients Discharged from Non-Neurology Services (P2.068)

Objective: To describe differences in stroke care quality metrics among acute ischemic stroke (AIS) patients discharged from non-neurology services following implementation of a comprehensive stroke center (CSC) program. Background: CSC designation defines hospitals capable of providing organized, high quality, guideline concordant stroke care. Standard stroke care is expected for all patients treated within a CSC, not only those admitted to a neurologic service line. Existing literature has described clinical characteristics of patients admitted to non-neurology services, but data reporting the quality of stroke care received by these patients is limited. Design/Methods: AIS discharges were identified by ICD-9 diagnosis codes between 1/1/2012–9/30/2015. We excluded in-hospital deaths, patients cared for during the washout period (11/1/2013–5/31/2014), as well as patients admitted to or discharged from the neurologic service line. Patients were divided into pre- and post- CSC designation groups for analysis. Quality metrics of interest included: stroke severity documentation, venous thromboembolism (VTE) prophylaxis, dysphagia screening, rehabilitation assessment, stroke education and secondary stroke prevention (SSP) medication use in the hospital and at discharge. Results: We identified 410 AIS patients, 239 in the pre-CSC period and 171 in the post-CSC period. Following CSC designation, patients were at higher odds of receiving stroke severity documentation (OR 3.41, 95%CI 2.19–5.31, p Conclusions: CSC designation is associated with improvement in several quality metrics among AIS patients discharged from non-neurology services. Areas for improvement remain, particularly in the provision of dysphagia screening and stroke education. Disclosure: Dr. Gibson has nothing to disclose. Dr. Albright has nothing to disclose. Dr. Ellison has nothing to disclose. Dr. Lyerly has nothing to disclose.