Cuyahoga County Operation Stroke Speed of Emergency Department Evaluation and Compliance With National Institutes of Neurological Disorders and Stroke Time Targets

Background and Purpose— Although the National Institutes of Neurological Disorders and Stroke (NINDS) has established time targets for the evaluation of acute stroke patients, little is known about how often these targets are met in the community. To track compliance with NINDS guidelines, Cuyahoga County Operation Stroke implemented a countywide data collection process that provides comparative reporting of hospital performance. Methods— Data on the emergency department evaluation of stroke patients have been retrospectively collected since January 2000 by hospitals participating in Cuyahoga County Operation Stroke. All hospitals used a 1-page form that includes NINDS time target information. Results— Median time to emergency department arrival for the 1003 patients in this cohort was 115 minutes; 382 patients (38%) arrived in <3 hours; 506 (50%) arrived in <6 hours. After arrival, median time to physician contact was 12 minutes, time to CT was 65 minutes, and time to imaging results was 105 minutes. Ear...