TY - JOUR
T1 - Impact of an Expanded Hospital Recognition Program for Stroke Quality of Care
AU - Heidenreich, Paul A.
AU - Zhao, Xin
AU - Hernandez, Adrian F.
AU - Schwamm, Lee H.
AU - Smith, Eric
AU - Reeves, Mat
AU - Peterson, Eric D.
AU - Fonarow, Gregg C.
N1 - Publisher Copyright:
© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
PY - 2017/1/21
Y1 - 2017/1/21
N2 - BACKGROUND: In 2009, the Get With The Guidelines-Stroke (GWTG-Stroke) program offered additional recognition if hospitals performed well on certain stroke quality measures. We sought to determine whether quality of care for all hospitals participating in GWTG-Stroke improved with this expanded recognition program.METHODS AND RESULTS: We examined hospital-level performance on 6 quality of care (process) measures and 1 defect-free composite quality measure for stroke following expansion of the existing performance measure recognition program. Compliance with all measures improved following launch of the expanded program, and this rate increased significantly for all 9 measures. When evaluated as the relative rate of increase in use over time, process improvement slowed significantly (P<0.05) following launch of the program for 2 measures, and accelerated significantly for 1 measure. However, when evaluated as a gap in care, the decrease in the quality gap was greater following launch of the program for 5 of 6 (83%) measures. There was no evidence that other processes of stroke care suffered as the result of the increase in measures and expanded recognition program.CONCLUSIONS: While care for stroke continues to improve in this country, expanded hospital process performance recognition had mixed results in accelerating this improvement. However, the quality gap continues to shrink among those participating in provider performance programs.
AB - BACKGROUND: In 2009, the Get With The Guidelines-Stroke (GWTG-Stroke) program offered additional recognition if hospitals performed well on certain stroke quality measures. We sought to determine whether quality of care for all hospitals participating in GWTG-Stroke improved with this expanded recognition program.METHODS AND RESULTS: We examined hospital-level performance on 6 quality of care (process) measures and 1 defect-free composite quality measure for stroke following expansion of the existing performance measure recognition program. Compliance with all measures improved following launch of the expanded program, and this rate increased significantly for all 9 measures. When evaluated as the relative rate of increase in use over time, process improvement slowed significantly (P<0.05) following launch of the program for 2 measures, and accelerated significantly for 1 measure. However, when evaluated as a gap in care, the decrease in the quality gap was greater following launch of the program for 5 of 6 (83%) measures. There was no evidence that other processes of stroke care suffered as the result of the increase in measures and expanded recognition program.CONCLUSIONS: While care for stroke continues to improve in this country, expanded hospital process performance recognition had mixed results in accelerating this improvement. However, the quality gap continues to shrink among those participating in provider performance programs.
KW - awards
KW - health care quality assessment
KW - health care quality indicators
KW - hospital performance
KW - performance measure
KW - stroke
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U2 - 10.1161/JAHA.116.004278
DO - 10.1161/JAHA.116.004278
M3 - Article
C2 - 28110310
AN - SCOPUS:85040172617
SN - 2047-9980
VL - 6
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 1
ER -