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 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, the median time from ED arrival to administration of tPA for ischemic stroke patients at MGH was 40 minutes. For this same time period, the median times for Academic Hospitals and Massachusetts Primary Stroke Service (PSS) Hospitals were 54 minutes and 59 minutes, respectively.

  • Current Scores
  • Scores Over Time
  • Lower values are better
59 54 40

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 7, 2016

40 45 53.5 46.5 35 40 46 43 74 70 81 77 63 59 68 64 75 71 78 75 58 54 67 61

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. MGH has participated in Target: Stroke, a national campaign launched in 2010 to integrate 10 best practices and reduce time from patient arrival in the ED to 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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