Get With the Guidelines® - Stroke Measures

Stroke Gold Plus logo

Dedicated to improving hospital-based stroke care, Get With The Guidelines® — Stroke was created in 2003 by the American Heart Association/American Stroke Association. The program measures a hospital’s adherence to the latest scientific treatment guidelines. Since 2003, 1,656 hospitals have added more than two million patient records to the Get With The Guidelines — Stroke database. Multiple studies based on these records show the impact the program has had on improving patient outcomes.

Froedtert & the Medical College of Wisconsin’s Stroke and Neurovascular Center has two high-level distinctions awarded by the American Heart Association/American Stroke Association.

  1. The Gold Plus Award
    The highest Get With The Guidelines — Stroke performance achievement award recognizes our dedication and success in achieving the highest standard of stroke care in each of seven nationally accepted core quality measures.
  2. Comprehensive Stroke Center Certification
    Froedtert & the Medical College is the only organization in eastern Wisconsin awarded the highest level of recognition dually awarded by The Joint Commission and the American Heart Association/American Stroke Association.

Composite Measure of Get With The Guidelines® — Stroke Measures

A hospital is scored on how well it implements seven key quality measures established by the American Heart Association/American Stroke Association. The seven Get With The Guidelines — Stroke measures include:

  1. Percent of acute ischemic stroke patients who arrive at the hospital within 120 minutes (2 hours) of time last known well and for whom IV t-PA was initiated at this hospital within 180 minutes (3 hours) of time last known well. Corresponding measure available for inpatient stroke cases.
  2. Percent of patients with ischemic stroke or TIA who receive antithrombotic therapy by the end of hospital day two. Corresponding measure available for inpatient stroke cases.
  3. Percent of patients with ischemic stroke, hemorrhagic stroke, or stroke not otherwise specified who receive VTE prophylaxis the day of or the day after hospital admission.
  4. Percent of patients with an ischemic stroke or TIA prescribed antithrombotic therapy at discharge. Corresponding measure available for inpatient stroke cases.
  5. Percent of patients with an ischemic stroke or TIA with atrial fibrillation/flutter discharged on anticoagulation therapy. Corresponding measure available for inpatient stroke cases.
  6. Percent of patients with ischemic or hemorrhagic stroke, or TIA with a history of smoking cigarettes, who are, or whose caregivers are, given smoking cessation advice or counseling during hospital stay. Corresponding measure available for inpatient stroke cases.
  7. Percent of ischemic stroke or TIA patients with LDL ≥ 100, or LDL not measured, or on cholesterol-reducer prior to admission who are discharged on statin medication. Corresponding measure available for inpatient stroke cases.

This chart displays an overall (composite) score representing the seven measures combined for Froedtert and the Medical College of Wisconsin. The chart also provides a comparison to Midwest hospitals participating in the Get With The Guidelines initiative and all hospitals participating across the country. The scores are averaged during the years noted. The higher the score, the better.

Get With the Guidelines - Stroke
  • “GWTG-Stroke Performance Award Goal” indicates the percentage of compliance required for a hospital to be designated a Get With The Guidelines-Stroke (GWTG-Stroke) Performance Award recipient. GWTG-Stroke is the American Stroke Association’s process for continuous quality improvement of acute stroke treatment and ischemic stroke prevention. The program helps hospitals collect and analyze stroke data, and provides a way for physicians and hospital staff to monitor their performance. GWTG-Stroke focuses on care team protocols to ensure that patients are treated and discharged appropriately.
  • “Midwest” represents Midwest hospitals participating in GWTG-Stroke database.
  • “National Average” represents all hospitals participating in GWTG-Stroke database.
The above information addresses the Institute of Medicine’s aim for health care that is effective.

FAST — When Minutes Count

The Froedtert & the Medical College Acute Stroke Team (FAST) is available 24 hours a day, seven days a week. This acute response team provides stroke patients with rapid access to diagnosis and treatment. Stroke neurologists, critical care neurologists, neuroradiologists, neurosurgeons, interventional neurologists, emergency medicine physicians and nurse specialists work around the clock to beat stroke.

The above information addresses the Institute of Medicine’s aim for health care that is timely.

Clot-Busting Drugs and Endovascular Therapy

Studies show that thrombolytic drugs, or clot-busters, effectively stop strokes and improve patient outcomes if specialists trained in giving the drugs are immediately available. All FAST doctors are trained to administer clot-busters and have been successfully using them since their approval in 1996. Some of these miracle drugs need to be administered intravenously within the first three hours of the onset of symptoms. It’s another reason to act fast when stroke symptoms occur.

Froedtert & the Medical College of Wisconsin consistently treats a higher percentage of stroke patients with stroke-stopping thrombolytic therapy. If patients arrive at the hospital too late for effective use of IV tPA or if IV tPA is not appropriate for them, physicians may use endovascular surgery procedures or neuro-interventional techniques to remove the clot. Endovascular procedures are those performed from inside the blood vessel so that tPA can be injected at the site of the blockage to dissolve the clot. Alternatively, a device can be used to suction or trap the clot and remove it.

The above information addresses the Institute of Medicine’s aim for health care that is timely.