Implementation of Best Practices-Developing and Optimizing Regional Systems of Stroke Care: Design and Methodology.

Autor: Ehrlich ME; Department of Neurology, Duke University School of Medicine, Durham, NC. Electronic address: Matthew.ehrlich@duke.edu., Kolls BJ; Department of Neurology, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC., Roettig M; Duke Clinical Research Institute, Durham, NC., Monk L; Duke Clinical Research Institute, Durham, NC., Shah S; Department of Neurology, Duke University School of Medicine, Durham, NC., Xian Y; Department of Neurology, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC., Jollis JG; Duke Clinical Research Institute, Durham, NC; Division of Cardiology, Duke University School of Medicine, Durham, NC., Granger CB; Duke Clinical Research Institute, Durham, NC; Division of Cardiology, Duke University School of Medicine, Durham, NC., Graffagnino C; Department of Neurology, Duke University School of Medicine, Durham, NC.
Jazyk: angličtina
Zdroj: American heart journal [Am Heart J] 2020 Apr; Vol. 222, pp. 105-111. Date of Electronic Publication: 2020 Jan 15.
DOI: 10.1016/j.ahj.2020.01.004
Abstrakt: The AHA Guidelines recommend developing multi-tiered systems for the care of patients with acute stroke. 1 An ideal stroke system of care should ensure that all patients receive the most efficient and timely care, regardless of how they first enter or access the medical care system. Coordination among the components of a stroke system is the most challenging but most essential aspect of any system of care. The Implementation of Best Practices For Acute Stroke Care-Developing and Optimizing Regional Systems of Stroke Care (IMPROVE Stroke Care) project, is designed to implement existing guidelines and systematically improve the acute stroke system of care in the Southeastern United States. Project participation includes 9 hub hospitals, approximately 80 spoke hospitals, numerous pre-hospital agencies (911, fire, and emergency medical services) and communities within the region. The goal of the IMPROVE Stroke program is to develop a regional integrated stroke care system that identifies, classifies, and treats acute ischemic stroke patients more rapidly and effectively with reperfusion therapy. The project will identify gaps and barriers to implementation of stroke systems of care, leverage existing resources within the regions, aid in designing strategies to improve care processes, bring regional representatives together to agree on and implement best practices, protocols, and plans based on guidelines, and establish methods to monitor quality of care. The impact of implementation of stroke systems of care on mortality and long-term functional outcomes will be measured.
Competing Interests: Disclosures ME Ehrlich: discloses salary support from IMPROVE grant funding by The Medtronic Foundation, and Daiichi Sankyo. BJ Kolls: discloses salary support from IMPROVE grant funding by The Medtronic Foundation. M Roettig: No disclosures. L Monk: discloses salary support from IMPROVE grant funding by The Medtronic Foundation, Daiichi Sankyo and Chiesi. S Shah: discloses salary support from IMPROVE grant funding by The Medtronic Foundation, and Daiichi Sankyo. Y Xian: discloses research grants from the American Heart Association, Daiichi Sankyo, Jansen Pharmaceuticals and Genentech, and honorarium from Boehringer Ingelheim and Portola. JG Jollis: discloses consultancy for Genentech. CB Granger: discloses salary support from AKROS, Apple, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Duke Clinical Research Institute, Glaxo Smith Kline, Medtronic Foundation, Pfizer; research support from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Duke Clinical Research Institute, Food and Drug Administration, Glaxo Smith Kline, Janssen Pharamceutica, Medtronic Foundation, Novartis, Pfizer; Consulting for Abbvie, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, CeleCor Therapeutics, Espero BioPharma, Janssen Pharmaceutica, Medscape LLC, Medtronic Inc., Merck, NIH, Novo Nordisk, Novartis, Pfizer, and Roche Diagnostics. C Graffagnino: discloses salary support from IMPROVE grant funding by Medtronic Foundation; medical consultancy and clinical trial support from Daichi Sankyo; medical consultancy for Portola and research funding from Chiesi.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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