Performance Feedback Improves Quality of Care for Ischemic Stroke
A performance feedback intervention reduced the time from door to groin puncture for patients with ischemic stroke, according to study results published in JAMA Neurology.
“This study found that performance feedback provided through a dashboard used by local quality improvement teams reduced door-to-groin puncture time for endovascular thrombectomy,” wrote first author Daniël Hansen, MD, of Erasmus MC University Medical Center, Rotterdam, the Netherlands, and coauthors of the study.
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The cluster randomized clinical trial included all patients with ischemic stroke who underwent endovascular thrombectomy at 13 Dutch hospitals between January 1, 2020, and June 30, 2022. Researchers were interested in the effect of an intervention that provided feedback on endovascular thrombectomy treatment times using structure, process, and outcome indicators.
“Performance feedback was provided through a dashboard for local quality improvement teams who developed and implemented improvement plans based on the feedback,” the study authors explained. “Every 6 months, 3 to 4 randomly selected hospitals switched to the intervention condition.”
The study included 4747 patients. Among them, the average age was 72 years, and 49.2% were women. At baseline, the median National Institutes of Health Stroke Scale score was 14.
The median time from door to groin puncture was 47 minutes (the interquartile range was 25-71 minutes) under the intervention condition and 52 minutes (interquartile range 29-75) minutes under the control condition, according to the study.
The intervention was associated with an adjusted absolute reduction in door-to-groin puncture time of 5 minutes, researchers reported, for a relative reduction of 9.2%.
“Implementation of performance feedback in hospitals providing endovascular thrombectomy can improve the quality of care for ischemic stroke,” researchers concluded.
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