Other Stroke Measures



Door to IV tPA: Median Time

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 amount of time it takes for eligible ischemic stroke patients to receive IV tPA after their arrival to the Emergency Department (ED). 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 2016, the median time from ED arrival to administration of tPA for ischemic stroke patients was 42 minutes at MGH. Performance was better than the median times for both academic hospitals (46 minutes) and Massachusetts Primary Stroke Service (PSS) sites (54 minutes). MGH is also participating 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. MGH has surpassed the goal to treat at least 50% of tPA cases within 60 minutes of arrival and ranks among the top U.S. hospitals on this measure.

  • Current Scores
  • Scores Over Time
  • Lower values are better
54 46 42

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: Sep 22, 2017

43 46 45 42 40 35 64 68 70 54 59 63 61 67 71 46 54 58

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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