Absence of July Phenomenon in Acute Ischemic Stroke Care Quality and Outcomes

BackgroundLower care quality and an increase in adverse outcomes as a result of new medical trainees is a concept well rooted in popular belief, termed the “July phenomenon.” Whether this phenomenon occurs in acute ischemic stroke has not been well studied. Methods and ResultsWe analyzed data from patients admitted with ischemic stroke in 1625 hospitals participating in the Get With The Guidelines–Stroke program for the 5‐year period between January 2009 and December 2013. We compared acute stroke treatment processes and in‐hospitals outcomes among the 4 quarters (first quarter: July–September, last quarter: April–June) of the academic year. Multivariable logistic regression models were used to evaluate the relationship between academic year transition and processes measures. A total of 967 891 patients were included in the study. There was a statistically significant, but modest (<4 minutes or 5 percentage points) difference in distribution of or quality and clinical metrics including door‐to‐computerize...