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 of the brain causes damage to brain tissue. Tissue plasminogen activator (tPA) is a drug used to dissolve the blood clots that cause this blockage and restore normal blood flow. The medication should be administered within 4.5 hours of stroke symptoms.

It is estimated that 2 million nerve cells die for every minute that brain ischemia remains untreated. Therefore, reducing the time to treatment is a critical intervention in the management of acute stroke. MGH tracks the percentage of eligible ischemic stroke patients who received IV tPA within 3 hours, as well as the percent who are treated within 60 minutes of Emergency Department (ED) arrival. To qualify for IV tPA, patients must arrive to MGH within the first few hours of symptoms. The administration of tPA to carefully screened, eligible acute ischemic stroke patients has been shown to significantly improve patient outcomes.

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

In 2017, 88% of eligible stroke patients at MGH were treated with tPA within 60 minutes of their arrival to the ED. Performance exceeded the average rates for both academic hospitals and Massachusetts Primary Stroke Service (PSS) sites. It is important to note that a relatively low number of cases qualified for this measure, as patients are often transferred to MGH for a higher level of care after receiving tPA at an outside hospital.

MGH participates in Target: Stroke, a national campaign to operationalize 10 best practices aimed at reducing the time from patient arrival in the ED to the start of tPA treatment. It has surpassed the goal to treat at least 75% of tPA cases within 60 minutes of arrival and ranks among the top U.S. hospitals on this measure.

  • Current Scores
  • Scores Over Time
  • Higher values are better
68% 85% 88%

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

MGH and GWTG Data Report: Jan 15, 2019

97 93 71 97 88 96 97 54 44 38 53 68 65 61 65 47 36 70 85 82 78

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



What are we doing to improve?

The MGH Acute Stroke Quality Task Force routinely monitors the 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 narrow the 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, common signals include sudden numbness or weakness of the face, arms, or legs, especially on one side of the body; confusion or trouble speaking/understanding others; difficulty seeing in one or both eyes; trouble walking, dizziness, or loss of balance/coordination; or, a 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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