Compliance With the Stroke Education Performance Measure in the Michigan Paul Coverdell National Acute Stroke Registry

Abstract

ResultsThe average age of the 9609 admissions was 69.2 years; 31% were nonwhite, 62.3% had ischemic stroke, 10.3% hemorrhagic stroke, 24.1% TIA, and 3.3% stroke not specified.Background and Purpose-Stroke education, 1 of 8 endorsed stroke performance measures, consists of 5 specific subcomponents: risk factors, stroke warning signs, emergency medical service activation, physician follow-up, and discharge medications. We identified predictors of stroke education performance measure compliance in the Michigan Paul Coverdell National Acute Stroke Registry. Methods-Data were collected on 9609 acute stroke admissions to 20 registry hospitals during 2008 and 2009. Predictors of measure compliance (delivery of all 5 subcomponents) were determined using multivariable logistic regression. Results-Overall compliance with the stroke education measure was 61.8% (hospital-level compliance ranged between 16% and 93%). Compliance with individual subcomponents were risk factors (65.5%), stroke warning signs (68.9%), emergency medical service activation (66.8%), physician follow-up (92.9%), and discharge medications (91.5%). Age, gender, stroke subtype, prestroke ambulation, discharge destination, and hospital size were all significant independent predictors of compliance. Stroke education was delivered less often to patients who were ≥70 years of age, nonambulatory prestroke, not discharged to home, had transient ischemic attack, or hemorrhagic stroke. Conclusions-Only 60% of patients received stroke education consistent with the endorsed performance measures.Strategies to increase stroke education, including the impact of incorporating stroke-specific education measures into hospital care protocols, should be explored. (Stroke. 2013;44:1459-1462.)

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