Other Stroke Measures



Door to IV tPA: Percent (%) within 60 Minutes

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% of eligible stroke patients were treated with tPA within 60 minutes of ED arrival. This result is considerably better than the average rates for Academic Hospitals and Massachusetts Primary Stroke Service (PSS) Hospitals.

  • Current Scores
  • Scores Over Time
  • Higher values are better
52% 62% 95%

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

80 65 62 73 89 95 79 70 34 37 24 30 46 52 43 44 31 36 26 30 55 62 42 50

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?

The MGH Acute Stroke Quality Task Force routinely monitors time from ED arrival to tPA treatment and shares data to drive improvement. In 2009, MGH implemented an "ED2CT" pager notification, which alerts all members of the Acute Stroke Team to the arrival of an acute stroke patient in the ED. This system helps to reduce time to CT scan and, most importantly, tPA treatment.

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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