Wisconsin Coverdell Stroke Program

Wisconsin Stroke CoalitionKalahari Resort & Convention Center

March 21, 2013

Dot Bluma, RNMetaStar, QI Stroke Specialist

Objectives

• Overview of Coverdell

• Define the objectives, benefits and goals of Coverdell participation in Wisconsin

• Describe baseline data, Coverdell vs WI Hospitals

Coverdell’s History2001 Paul Coverdell National Acute Stroke Registry (PCNASR) was established by the CDC

• Georgia Senator died while serving in Congress• Initial three-year pilot study showed large gaps between national

recommended guidelines and hospital practices. 2004 Four states chosen to implement state-wide stroke registries (GA, IL, MA,

NC)2007 Increased number of participating states to six: (GA, MA, NC, MI, MN, OH)

Increased funding cycle from three years to five years• Collaborated with The Joint Commission & American Heart Association to

adopt standardized stroke measure set. Sep. 2012 Wisconsin chosen to receive funding. Eleven states participating in registry

Coverdell ObjectivesCoverdell focuses on the continuum of patient care:• Measure, track, and improve the quality of care and access to care

for stroke patients from onset of stroke symptoms through rehabilitation and recovery.

• Decrease rate of premature death and disability from acute stroke.• Eliminate disparities in care.• Support development of stroke systems of care that emphasize

quality of care.• Improve access to rehabilitation and opportunities for recovery

after stroke.• Increase the workforce capacity and scientific knowledge for

stroke surveillance within stroke systems of care.

Coverdell goals for Wisconsin2013 Year 1 strategies: Infrastructure and Development

• Hired Stroke QI Specialist staff contracted through MetaStar• Interviewing EMS QI Specialist• Hospital recruitment efforts for participation in QI Project. Current recruitment

of 27 participating or interested hospitals with a goal of 30. • Continuation of Stroke Coordinator of Wisconsin meeting• Identify Coverdell baseline data to devise a quality improvement plan for the

state.• EMS QI participation will target those EMS providers servicing the participating

hospitals• Reconvene Wisconsin Stroke Coalition• Develop statewide Stroke Systems of Care

Current Stroke Quality Improvement Projects in WI

• Stroke Coordinator group: All WI hospital stroke coordinators are invited to attend quarterly meetings

• Wisconsin Hospital Association: Publically reporting of stroke quality measures on Checkpoint

• Office of Rural Health Stroke Quality Improvement Project• EMS: 98.6% of all WI EMS runs are entered into the WARDS

Systems, little data analysis is currently completed.

Stroke Quality Improvement Goals

• Stroke QI Specialist to develop chart reabstraction process to ensure abstraction reliability.

• State Coordinator Committee meetings which:– Provide the ability to participate in performance

improvement collaboratives which help to focus on a topic and share challenges and solutions with other hospitals in a safe, neutral environment.

– Ability to get connected with other hospitals and share informally how to address common challenges.

Stroke Quality Improvement Goals(continued)

• Educational offerings in collaboration with participating Coverdell states.

• Free access to technical assistance (data analysis, educational resources, and other QI support) from the Wisconsin Department of Health, American Heart Association and MetaStar

Benefits of Joining Wisconsin Stroke Coverdell Registry

• Additional QI support for ongoing hospital projects• Dedicated project leadership • Improved outcomes • Increased collaboration with EMS providers and referring

hospitals• Participation in development of stroke systems of care in

Wisconsin• Funding support: Participating hospitals by June 30, 2013 will

receive a one time $1000 stipend• Educational opportunities

Standardized Stroke Measure Set

• IV rt-PA Arrive by 2 Hour, Treat by 3 Hour• Early Antithrombotics• VTE Prophylaxis• Antithrombotics • Anticoag for AFib/Aflutter• Smoking Cessation • LDL 100 or ND - Statin• Dysphagia Screen• Stroke Education• Rehabilitation Considered

IV rt-PA Arrive by 2 Hour, Treat by 3 Hour

Early Antithrombotics

VTE Prophylaxis

Antithrombotics

Anticoag for AFib/AFlutter

Smoking Cessation

LDL 100 or ND - Statin

Dysphagia Screen

Stroke Education

Rehabilitation Considered

Questions?

Thank you