Designation Project Quality improvement in acute stroke: The New York State Stroke Center

Abstract— Background: Many hospitals lack the infrastructure required to treat patients with acute stroke. The BrainAttack Coalition (BAC) published guidelines for the establishment of primary stroke centers. Objective: To determine ifstroke center designation and selective triage of acute stroke patients improve quality of care. Methods: Baseline chartabstraction was performed on all stroke patients admitted to 32 hospitals serving Brooklyn and Queens, NY, from Marchto May 2002. Hospitals were invited to meet BAC guideline-based criteria. Adherence was verified by on-site visits. Afterdesignation, acute stroke patients were selectively triaged. Remeasurement data were collected from August to October2003. Results: The authors abstracted 1,598 charts at baseline and 1,442 charts at remeasurement. From baseline toremeasurement, median times decreased for door to physician contact (25 vs 15 minutes, p 0.001), CT performance forpotential tissue plasminogen activator (t-PA) candidates (68 vs 32 minutes,