Improving Care for Patients Experiencing Stroke Symptoms

Standardized Tools and Protocols Across Vermont Hospitals

Project Summary

Stroke kills approximately 129,000 Americans every year, making it the fifth leading cause of death in the nation. Stroke is also the fifth leading cause of death in Vermont, behind cancer, heart disease, chronic lower respiratory diseases, accidents/unintentional injuries, and Alzheimer’s. Early identification of stroke symptoms, rapid evaluation by medical professionals, effective communication between the care providers at the first sign of a stroke along with high quality, consistent treatment of these patients provide the strongest means for reducing the effects of stroke.

In 2009, Act 61 charged the Vermont Association of Hospitals and Health Systems with convening a work group of neurologists, emergency department physicians, and representatives of the American Heart Association (AHA) with developing recommendations to improve acute stroke care in our state. One key recommendation was to incorporate the standardized tools and materials developed by the work group into hospitals throughout Vermont. These tools and materials are designed to ensure patients receive timely and appropriate stroke care, and emphasize:

  • quick recognition of stroke symptoms by the patient, family member and/or care provider
  • correct identification of stroke symptoms with appropriate treatment provided by Emergency Medical Services (EMS)
  • critical, accurate and efficient communication between EMS and the ED staff
  • rapid patient assessment by hospital staff
  • implementation of the standardized stroke treatment protocol

To carry out the recommendations from the work group, the state of Vermont contracted with VPQHC. Since 2011, we have worked closely with physician leaders, the Vermont Department of Health, EMS, and ED Nurse Leadership to standardize stroke protocols and tools, with the goal of improving treatment time. VPQHC has also implemented an electronic acute stroke chart audit tool to support continued evaluation of acute stroke care across the state.

Recommendations and Next Steps

VPQHC and the stroke work group will continue to collaborate with providers to aid in the implementation of stroke and TIA standardized tools and guidelines. These tools and guidelines will serve to support high quality patient care across Vermont hospitals. VPQHC will also continue to evaluate acute stroke care processes through its electronic chart audit tool, which will provide essential feedback for hospitals to guide improvements.