Strategies for improving outcomes in the acute management of ischemic stroke in rural emergency departments: a quality improvement initiative in the Stroke Belt

Figures & data

Figure 1 Initiative components.

Abbreviations: EHR, electronic health record; AIS, acute ischemic stroke; CME/CE, Continuing Medical Education/Continuing Education.

Table 1 Emergency department team members responding to baseline electronic survey by degree type (N = 45)

Respondent	n (%)
MD/DO	14 (31.1)
NP/PA	6 (13.3)
Nurse	23 (51.1)
Other	2 (4.4)

Abbreviations: MD, medical doctor; DO, doctor of osteopathy; NP, nurse practitioner; PA, physician assistant.

Table 2 Clinicians’ baseline estimation of the percentage of patients with acute ischemic stroke treated with alteplase within 60 minutes of emergency department arrival

	Number of respondents	Average percentage of patients receiving alteplase ≤60 minutes
Overall*	43	69.2%
By clinician type
MD/DO	14	80.6%
Nurse	23	60.9%
NP/PA	6	74.2%

Note: *Does not include 2 respondents who were nonclinician emergency department staff.

Abbreviations: MD, medical doctor; DO, doctor of osteopathy; NP, nurse practitioner; PA, physician assistant.

Figure 2 Perceived vs. actual percentage of patients with acute ischemic stroke who receive alteplase within 60-minute door-to-needle window at the start of the initiative.

Figure 3 Patients with acute ischemic stroke receiving alteplase over the 6-month intervention period (all participating emergency departments combined).

Notes: (A) Percentage of eligible patients receiving alteplase ever, within 3 hours, and within 60 minutes. (B) Percentage of eligible patients receiving alteplase more than 60 minutes after arrival in the emergency department.