Intervention to Bridge the Evidence-based Gap in Stroke Care Quality

Cluster-randomized Trial of a Targeted Multifaceted Intervention to Bridge the Evidence-based Gap in the Management of Acute Ischemic Stroke

The purpose of this study is to evaluate whether a multifaceted quality improvement intervention can improve the adherent rate of individual and composite of evidence-based performance measures for patients with acute ischemic stroke within the first 7 days of symptom onset and reduce the incidence of a new clinical vascular event, disability, and all-cause mortality at discharge and long term clinical outcome.

Study population:

patients with acute ischemic stroke who were admitted to the hospital within 7 days after the initial symptom onset.

Program:

There are multifaceted quality improvement interventions including:

1. Evidence-based clinical pathway
2. Standard operating procedures (SOP) of performance indicators
3. A quality coordinator
4. Monitoring and feedback system of performance measures

Endpoints:

Primary outcome:increase of adherence of evidence based treatment in clinical practice; Secondary outcome: total mortality, disability, and major cerebrovascular events

Inclusion criteria:

• Older than 18
• Ischemic stroke within 7 days of the index event
• Direct admission based on physician evaluation or arrival through the emergency department
• Ability of patient or legally authorized representative to provide informed consent for 3, 6,and 12 months after initial symptom onset
• Eligible events were confirmed by brain ct or mri within7 days after the onset of symptoms

Exclusion criteria:

• Patients refuse to participate in this study