Background & Purpose: National guidelines recommend door-to-needle (DTN) times <60 minutes for stroke thrombolysis. Several best practices have been reported to be associated with decreased DTN times. The extent to which hospitals of varying sizes are implementing these strategies has not been well studied. Target Stroke is a national initiative sponsored by AHA/ASA to assist hospitals in increasing the proportion of IV-tPA treated patients who achieve guideline recommended DTN within 60 minutes. Illinois Get With The Guidelines hospitals have been participating in the Target Stroke initiative since 2011.
Methods: We reviewed aggregate data from the Illinois Get With The Guidelines stroke registry benchmark, including data from 24 critical access hospitals participating in Target Stroke as part of the Illinois Critical Access Hospital Network stroke systems of care initiative.
Results: Aggregate data from 78 hospitals, representing 2394 patient records, demonstrates the overall decrease in median DTN times in ALL IL hospitals, including 24 ICAHN critical access hospitals. Primary Stroke Centers, community hospitals and 25 bed or less critical access hospitals implemented Target Stroke strategies during the 4 year period of Target Stroke implementation.
Conclusion: Target Stroke strategies can improve timely intervention in hospitals regardless of hospital size. Critical access hospitals also demonstrated steady decrease in DTN times over four years. Further research is needed to identify which strategies are most effective in decreasing DTN times in the various size hospitals.