Information about Hospital Performance

Performance rates tell you the proportion of cases where a hospital provided the recommended process of care. Only patients meeting certain criteria are included in the calculation of the rate for a measure. A rate of 75% means that the hospital provided the recommended process of care 75% of the time. For example, the rates for eligible stroke patients who received IV- tPA in MA PSS hospital Emergency Departments tells you the percentage of patients who received IV-tPA within three hours of the time they were last known to be well. The seven figures below represent how well hospitals are adhering to preset indicators of stroke care.

Time period: the data reported in the following bar graphs are from the time periods of January 2006 to December 2007 and January 2007 to December 2008.

Link to each figure by clicking on the title below.

Timeliness of Arrival to the Emergency Department

PSS regulations require that hospitals incorporate a stroke education component into their Community Education outreach efforts. While not indicators of hospital care, Figures 1 and 2 represent the timeliness of patient arrival to Emergency Departments. These data reveal the need for continued efforts to increase knowledge among the public of stroke signs and symptoms and the importance of calling 9-1-1.

  1. Percentage of all ischemic stroke patients who arrived at MA PSS Emergency Departments within two hours of the time that they were last known to be well Distribution of patient arrival times - 2006 to 2007 pdf format of pss-figure-1.pdf doc format of pss-figure-1.doc
    Percentage of all ischemic stroke patients who arrived at MA PSS Emergency Departments within two hours of the time that they were last known to be well Distribution of patient arrival times - 2007 to 2008 pdf format of pss-figure-1-2008.pdf rtf format of pss-figure-1-2008.rtf
  2. Distribution of Patient Arrival Times - 2006 to 2007 pdf format of pss-figure-2.pdf doc format of pss-figure-2.doc
    Distribution of Patient Arrival Times - 2007 to 2008 pdf format of pss-figure-2-2008.pdf rtf format of pss-figure-2-2008.rtf

Treatment with IV-tPA

IV-tPA is a proven intervention for eligible acute ischemic stroke patients who arrive at the Emergency Department within three hours from the time they were last known to be well. However, for a variety of reasons, only a small percentage of patients with acute ischemic stroke receive IV-tPA. The benefits of IV-tPA in acute ischemic stroke are based on time. The recommendation is to start treatment in eligible patients within 60 minutes of arrival at the Emergency Department. Figures 3-6 represent the rates of IV-tPA administration and timeliness of treatment.

  1. Percentage of all ischemic stroke patients who received IV-tPA within three hours of the time they were last known to be well - 2006 to 2007 pdf format of pss-figure-3.pdf doc format of pss-figure-3.doc
    Percentage of all ischemic stroke patients who received IV-tPA within three hours of the time they were last known to be well - 2007 to 2008 pdf format of pss-figure-3-2008.pdf rtf format of pss-figure-3-2008.rtf
  2. Percentage of eligible ischemic stroke patients who received IV-tPA - 2006 to 2007 pdf format of pss-figure-4.pdf doc format of pss-figure-4.doc
    Percentage of eligible ischemic stroke patients who received IV-tPA - 2007 to 2008 pdf format of pss-figure-4-2008.pdf rtf format of pss-figure-4-2008.rtf
  3. Percentage of ischemic stroke patients who received IV-tPA within 60 minutes from arrival - 2006 to 2007 pdf format of pss-figure-5.pdf doc format of pss-figure-5.doc
    Percentage of ischemic stroke patients who received IV-tPA within 60 minutes from arrival - 2007 to 2008 pdf format of pss-figure-5-2008.pdf rtf format of pss-figure-5-2008.rtf
  4. Median times (in minutes) from Emergency Department arrival to IV-tPA administration in IV-tPA recipients - 2006 to 2007 pdf format of pss-figure-6.pdf doc format of pss-figure-6.doc
    Median times (in minutes) from Emergency Department arrival to IV-tPA administration in IV-tPA recipients - 2007 to 2008 pdf format of pss-figure-6-2008.pdf rtf format of pss-figure-6-2008.rtf

Brain Imaging

Rapid brain imaging is a critical step in facilitating the use of IV-tPA. For patients in whom IV-tPA should be considered, brain imaging should be performed as rapidly as possible, ideally within 25 minutes of arrival to the Emergency Department. Figure 7 depicts those eligible ischemic stroke patients at MA PSS hospitals who met this time recommendation.

  1. Percentage of eligible ischemic stroke patients who had brain imaging completed within 25 minutes from arrival - 2006 to 2007 pdf format of pss-figure-7.pdf doc format of pss-figure-7.doc
    Percentage of eligible ischemic stroke patients who had brain imaging completed within 25 minutes from arrival - 2007 to 2008 pdf format of pss-figure-7-2008.pdf rtf format of pss-figure-7-2008.rtf