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June 10, 2009 > Stroke Program Receives Silver Performance Award

Stroke Program Receives Silver Performance Award

American Stroke Association Program Recognizes Life-Saving Stroke Measures

Washington Hospital's Stroke Program has received the Silver Performance Achievement Award as part of the American Stroke Association's (ASA) Get With The Guidelines-Stroke (GWTG-Stroke) program, a national evidence-based initiative to improve stroke patients' outcomes.

The ASA program recognizes hospitals across the country whose stroke treatment programs have shown consistent compliance with measures proven to maximize outcomes.

Doug Van Houten, R.N., clinical coordinator of Washington Hospital's Stroke Program, says voluntary compliance with initiatives like the one administered by the ASA, a branch of the American Heart Association, is vital for certified stroke centers.

"I think that the public is consumer savvy for a reason," he says. "Most people don't buy a particular car for the looks; they look at consumer reports and other resources that have recognition and credit for being a reputable source. The same goes for health care. Groups like the American Stroke Association and Joint Commission base everything they do on a scientific standard. By meeting these standards, our Stroke Program at Washington Hospital is committed to employing nationally and internationally approved guidelines that have been demonstrated to be effective by hundreds or thousands of studies.

"The more objective measures you can integrate into a program, the better. It's just another way to show we're on the right track. We are doing what the American Stroke Association says is right, what JCAHO says is right, and we follow the National Institutes of Health (NIH) protocols."

Van Houten, who serves as champion of the ASA program for Washington Hospital, is responsible for tracking the data and identifying areas for improvement. He points out that participation in the Get With The Guidelines program is voluntary and requires a concerted effort on the part of the stroke nurses that are responsible for collecting data and making sure that the program's guidelines are met.

"It's a significant job to keep up with all this data," he says. "We're talking about around 560 cases for one year - and that's a lot of data to enter into our data management tool. Our stroke nurses have to do the case management every day to work with physicians to discharge patients appropriately with all the measures the patient needs when he or she goes home.

"I think meeting the requirements of this program is the sort of thing that a stroke program should be able to do to ensure the best possible outcomes for patients."

The "Silver" level award is given to hospitals that have maintained an 85 percent or higher level of compliance with the American Stroke Association's program guidelines, which focus on secondary prevention of stroke, according to Van Houten.

Primary prevention includes things like exercise, improving diet and taking a baby aspirin to prevent a first stroke.

"When patients come into the hospital with a transient ischemic attack (TIA) or stroke, it's no longer about primary prevention, but secondary prevention now," Van Houten explains. "These are the measures put into place to keep patients from having a second stroke. For an ischemic stroke, we might recommend a daily aspirin regimen. For patients that smoke, we give them referrals to tobacco cessation counseling and support groups. In the case of patients with atrial fibrillation, we will prescribe anticoagulants. These are a few of the seven standard measures recommended by the ASA's Get With The Guidelines-Stroke program."

Van Houten says the reason he seeks out external quality improvement programs like the ASA's is because it encourages continuous improvement on the part of each member of the Stroke Program's team.

"I think it's good to be involved in quality improvement initiatives like this one and to compare our data with other stroke programs across the country to see how we size up," he says. "Some programs might think they're doing well if they're getting 50 percent compliance. The question we ask ourselves is 'How can we continue to improve?' A lot of these reputable organizations like the American Heart Association, American Stroke Association and Joint Commission - we stay in contact with them because they have important suggestions to make. That's the way to make a better program. You have to be connected, I think. I've tried to do my part to help other stroke programs because when we help each other, we can improve the outcome for stroke on a larger scale."

The Stroke Program was awarded the ASA's bronze-level performance achievement award last year for reaching three-months compliance. The silver performance achievement award is now recognizing 12 consecutive months of compliance, and Van Houten expects Washington Hospital's program to earn the gold achievement award, which is given when a hospital meets the guidelines for two consecutive years.

To learn more about Washington Hospital's Stroke Program, visit, click on "Services & Programs," select "Taylor McAdam Bell Neuroscience Institute" from the drop-down menu and choose "Stroke Program."

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