Overview

Information presented in the following tables describes Massachusetts Primary Stroke Service (PSS) designated hospital performance on the percentage of eligible patients who received intravenous tissue plasminogen activator (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.

The Data

A requirement of PSS designation is that hospitals collect data on all patients with acute stroke symptoms who arrived or may have arrived at their Emergency Department within three hours from when they were last known to be well. Data reported are from four two-year periods ranging from 2007 to 2011. The tables include only ischemic stroke patients who arrived at a PSS designated hospital Emergency Department within two hours of the time they were last known to be well.

The data are presented in four reports. One is a statewide report that lists the results of all hospitals and allows you to compare a hospital's performance to the overall statewide rate. The other three group hospitals by hospital characteristics which are called peer groups. This allows you to compare a hospital's performance to hospitals with the same characteristics and to compare the overall performance between hospitals in different groups. The three groupings or peer groups are 1); Hospital Location, 2); Hospital Size and 3); Hospital Teaching Status Designation. These groups were selected because they commonly are associated with variability in performance across hospitals.

Public Health Council Update on Hospital Quality Improvement Programs and Public Reporting - 8/8/2012 ppt format of PHC on Hospital Quality Improvement Programs
file size 2MB doc format of PHC on Hospital Quality Improvement Programs file size 4MB

2010-2011

2009-2010

2008-2009

2007-2008

These data show a wide range of performance on the administration of IV-tPA to eligible patients across 68 PSS designated hospitals. Statewide, 61.7% of all eligible patients received IV-tPA treatment compared to pss-figure-4-2008.pdf pdf format of pss-figure-4-2008.pdf
rtf format of pss-figure-4-2008.rtf for the same time period. Hospitals located in the Metro region tend to administer IV-tPA more frequently as do large hospitals with a bed-size of over 200 beds, and teaching hospitals.

The data highlight opportunities for improvement and the need to ensure consistent standards of care for IV-tPA eligible ischemic stroke patients. One significant element to improving the percent of eligible patients who receive IV-tPA is timely identification of stroke symptoms not only from EMS providers and providers in the Emergency Department, but also from the community. Data from a previously released PSS aggregate report pdf format of pss-figure-2-2008.pdf
rtf format of pss-figure-2-2008.rtf indicate that a large majority of stroke patients arrive at the ED beyond three hours from when they were last known to be well. This is often too late for effective treatment. Community education programs on the recognition of signs and symptoms of stroke and the need to promptly call 9-1-1 are a critical to providing quality treatment to more stroke victims.

See Basic Facts about Stroke to learn more about the signs and symptoms of stroke.