Other Stroke Measures



IV tPA - Arrive by 2 Hour, Treat by 3 Hour

What are we measuring and why?

Ischemic stroke is a type of stroke where a blockage in the blood vessels in the brain causes damage to brain tissue. Tissue plasminogen activator (tPA) is a drug used to dissolve the blood clots that cause the blockage, and restore normal blood flow.

MGH tracks the percent of eligible patients who received IV tPA. To be considered eligible for IV tPA, a patient must have had an ischemic stroke, arrived at MGH within the first few hours of the time they were last known to be well, and had tPA initiated within 4.5 hours of the time they were last known well. The administration of tPA to carefully screened, eligible, acute ischemic stroke patients has been shown to significantly improve patient outcomes.

MGH also tracks the percent of those ischemic stroke patients receiving IV tPA who are treated within 60 minutes of Emergency Department (ED) arrival. Every minute that brain ischemic continues untreated, 2 million nerve cells die. Therefore, reducing time to treatment is a critical intervention in the management of acute stroke patients arriving in the ED.

How are we doing and how do we compare to best practices?

In 2015, 96.7% of eligible stroke patients at MGH were treated with tPA within 3 hours of time last known well. This result is better than the average rates for Academic Hospitals and Massachusetts Primary Stroke Service (PSS) Hospitals. MGH is also participating in Target: Stroke, a national campaign launched in 2010 to integrate 10 best practices to help reduce time from patient arrival in the ED to the start of tPA treatment. MGH has exceeded the goal set for Target: Stroke (goal is 50% of all tPA cases treated within 60 min of arrival, MGH now treats 95% of tPA cases within 60 min of arrival) and ranks among the top US hospitals in the percentage of cases that get treated within 60 minutes of arrival.

  • Current Scores
  • Scores Over Time
  • Higher values are better
84% 92% 97%

MGH and Comparison Aggregate Data: This Get With The Guidelines (GWTG) Aggregate Data report was generated using the Outcome ™ PMT ® system.
Copy or distribution of the GWTG Aggregate Data is prohibited without prior written consent of the American Heart Association and Outcome Sciences, Inc. (Outcome).

MGH and GWTG Data Report: April 07, 2016

100 86 96 100 94 97 96 100 84 83 66 77 88 84 86 89 82 84 72 80 93 92 87 91

MGH and Comparison Aggregate Data: This Get With The Guidelines (GWTG) Aggregate Data report was generated using the Outcome ™ PMT ® system.
Copy or distribution of the GWTG Aggregate Data is prohibited without prior written consent of the American Heart Association and Outcome Sciences, Inc. (Outcome).



What are we doing to improve?

Because the time frame for administering tPA is limited to up to 4.5 hours after symptom onset, MGH educates its staff and the community on how to identify and respond to a stroke in a timely manner. We also have a new team dedicated to reducing the time from ED arrival to treatment with catheter-based acute stroke therapy.

What can you do?

It is important to learn the signs and symptoms of a stroke. According to the American Stroke Association, these signs include sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; or, sudden severe headache with no known cause.

If you think you might be having a stroke, call 911. Patients who arrive by ambulance get treated faster.

Useful Links

Massachusetts Department of Public Health Primary Stroke Service (PSS) data

 

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