Stroke quality scores

A stroke occurs when the blood supply to the brain is blocked or severely reduced, depriving the brain of the oxygen it needs to work properly. The American Heart Association/American Stroke Association and the The Joint Commission, an independent non-profit organization, have teamed up to create a program known as Get with the Guidelines®. This program was designed by national stroke experts who researched best practices and clinical science to identify which aspects of stroke care lead the best patient outcomes.

The quality scores below tell you how well Duke University Hospital follows the guidelines that are part of this program.

Stroke patients who received clot-busting treatment within 270 minutes after the onset of symptoms

2014 Data

(1) This average includes all hospitals with The Joint Commission Primary Stroke Certification (JC PSC)
Note: This Get With The Guidelines® Aggregate Data report was generated using the Outcome™ PMT® system. Copy or distribution of the GWTG Aggregate Data is prohibited without the prior written consent of the American Heart Association and Outcome Sciences, Inc.

What do these scores mean?

The percentage of eligible patients (out of 100) who received clot-busting treatment within 270 minutes (4.5 hours) after the onset of stroke symptoms.

Why are these scores important?

Fast diagnosis and treatment of a stroke will reduce negative effects of a stroke and permanent disability. Research has shown that patients who suffer a stroke as a result of a blockage in the artery of the brain have better outcomes when they receive clot-busting drugs within 270 minutes (4.5 hours) after the onset of symptoms.

Stroke education

Percent of patients with stroke or transient ischemic attack (TIA) or their caregivers who were given education and/or educational materials during the hospital stay addressing ALL of the following: personal risk factors for stroke, warning signs for stroke, activation of emergency medical system, need for follow-up after discharge, and medications prescribed.

The percentages in this chart cover the time period of January 1, 2014 - December 31, 2014.

  • (1) includes all Joint Commission-certified Comprehensive Stroke Centers. These Centers meet standards to treat the most complex stroke cases.

What do these scores mean?

The overall percentage of eligible patients (out of 100) who were given education and/or educational materials during the hospital stay addressing the following;  personal risk factors for stroke, warning signs for stroke, activation of emergency medical system, need for follow-up after discharge, and medications prescribed as reported through the Get With the Guidelines® program.

Why are these scores important?

Fast diagnosis and evidence-based treatment can reduce the negative effects of a stroke and improve your chances of avoiding permanent damage.  It is important that you are educated in these areas to help you quickly recognize and respond to the signs and symptoms of stroke, how to manage your medications and understand your follow-up care.  This score shows how often a hospital provides this education. 

Stroke outcomes for Duke University Hospital

  Duke University Hospital Comprehensive Stroke Center Standard
Diagnostic cerebral angiography 24-hour mortality 0% ≤ 1%
Cerebrospinal fluid infection rate for patients with a Ventriculostomy <1% N/A

The date range for the rates displayed in this table is July 2013 through July 2015.

Source: Comprehensive Stroke Center standards manual from the Joint Commission

What do these scores mean?

A cerebral angiography is a procedure that doctors use to look at the blood vessels in the brain. This procedure requires a catheter (long thin flexible plastic tube) to be placed into a large artery in your leg. The catheter travels through the blood vessels to the head. This allows your doctor to see if these blood vessels are clogged or are abnormal.

A ventriculostomy is a device that drains extra fluid from the head. The system has a small tube (placed directly in the brain), drainage bag, and monitor. This allows the healthcare team to drain extra fluid and monitor pressure on the brain.

Why are these scores important?

Any time a cerebral angiography is done, there is a risk for stroke or death. Duke University Hospital reports zero deaths in the 24 hours following this procedure. 

With ventriculostomies, there is a risk for infection because we are placing a tube directly into the brain. Duke University Hospital physicians and nurses have helped to keep this risk to less than 1% for our patients.

What are we doing to continue to improve our quality?