Minnesota Stroke Registry



Overview History About the MN Stroke Registry Participating Hospitals MSR Advisory Committee Information for Hospitals Benefits of Participation Enrollment Performance Measures Quality Improvement Data Collection Member Login Resources Stroke Facts and Figures Current Guidelines Links Downloads Announcements Contact Us	Announcements Subscribe to MSR Announcements To receive an email alert when new announcements are posted to this page, click on the envelope above to subscribe. You don't need a password, and can choose to unsubscribe at any time. This system (GovDelivery) also allows you to subscribe to many other MDH and CDC newsletters. Check it out! May 12, 2010 On Thursday, May 20 from 11:00 am to noon, Dr. Niloufar Hadidi will be presenting, "Emotions After a Stroke." This will be a 45 minute presentation with time for a question and answer session. Lunch will be served to those in attendance. Registration is required. Please contact Melissa Fritz: 651-241-7318 or Melissa.Fritz@allina.com. April 15 , 2010 Please note that registration for Minnesota Stroke Conference 2010: "Innovations and Improvements." is still open through April 30. Date of conference: May 11, 2010, Radisson Suite Hotel, St. Cloud. Visit the conference website at www.mnstrokepartnership.org/conference.html. Space is limited so please register soon! March 22, 2010 On March 30, 2010, Dr. Lee Schwamm will be presenting a webinar titled: Targeting Stroke: A Decade of Progress, a Decade of Possibility. This overview is particularly valuable in the context of Target: Stroke, the American Heart Association’s campaign to put proven best practice tools to work reducing door-to-needle times for acute ischemic stroke patients. Register now for a look at how stroke care has changed and where we go from here. 2:30 to 3:30 p.m. CT, Tuesday March 30, 2010 Webinar registration: http://gwtg.webex.com Call-in number: 1-888-398-0518 March 11, 2010 Please see our second Coverdell Data Story: "Pre-hospital transport and patient medical history" which can be downloaded for free from our Downloads page. January 27, 2010 The Minnesota Department of Health is hosting a statewide stroke conference for all hospitals in Minnesota. The conference theme is "Innovations and Improvements."May 11, 2010, Radisson Suite Hotel, St. Cloud. Visit the conference website at www.mnstrokepartnership.org/conference.html. Registration is now open (January 27) and closes April 30 - but space is limited so please register early. January 6, 2010 A review of the MMWR article: Researchers Hope Measuring Performance Will Improve Stroke Care and Prevention, by Mike Mitka (JAMA. 2010;303(1):17-18.) http://jama.ama-assn.org/cgi/content/full/303/1/17?etoc_ November 9, 2009 CDC MMWR Surveillance Summary (Vol 58, SS-7): Paul Coverdell National Acute Stroke Registry Surveillance Four States, 2005--2007 Each year, approximately 795,000 persons in the United States experience a new or recurrent stroke. Data from the prototype phase (2001–2004) of the Paul Coverdell National Acute Stroke Registry (PCNASR) suggested that numerous acute stroke patients did not receive treatment according to established guidelines. This report summarizes PCNASR data collected during 2005–2007 from Georgia, Illinois, Massachusetts, and North Carolina, the first states to have PCNASRs implemented in and led by state health departments. Adherence to acute stroke care measures defined by PCNASR were as follows: received antithrombotic therapy at discharge (97.6%), received antithrombotic therapy within 48 hours of admission or by the end of the second hospital day (94.6%), assessed for rehabilitation services (90.1%), received deep venous thrombosis prophylaxis (85.5%), received anticoagulation therapy for atrial fibrillation (82.5%), received smoking cessation counseling (78.6%), received lipid level testing (69.9%), received stroke education (58.8%), received dysphagia screening (56.7%), and received tissue plasminogen activator (among eligible patients) (39.8%). Results from PCNASR indicate the need for additional public health measures to inform the public of the need for timely activation of EMS services for signs and symptoms of stroke. In addition, low rates of adherence to certain measures of stroke care underscore the need for continuing coordinated programs to improve stroke quality of care. Download the MMWR article (pdf, 370 kb) Citywide Prehospital Protocol Increases Access to Stroke Thrombolysis in Toronto. Gladstone DJ , Rodan LH , Sahlas DJ , Lee L , Murray BJ , Ween JE , Perry JR , Chenkin J , Morrison LJ , Beck S , Black SE. From the North and East GTA-Ontario Regional Stroke Centre and Division of Neurology, Department of Medicine, and Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. BACKGROUND AND PURPOSE: Intravenous tissue plasminogen activator for ischemic stroke is approved for eligible patients who can be treated within a 3-hour window, but treatment rates remain disappointingly low, often <5%. To improve rapid access to stroke thrombolysis in Toronto, Canada, a citywide prehospital acute stroke activation protocol was implemented by the provincial government to transport acute stroke patients directly to one of 3 regional stroke centers, bypassing local hospitals. This comprised a paramedic screening tool, ambulance destination decision rule, and formal memorandum of understanding of system stakeholders. This report describes the initial impact of the activation protocol at our regional stroke center. METHODS: We compared consecutive patients with stroke arriving to our stroke center during the first 4 months of this new triage protocol (February 14 to June 14, 2005) versus the same 4-month period in 2004. RESULTS: The protocol resulted in an immediate doubling in the number of patients with acute stroke arriving to our regional stroke center within 2.5 hours of symptom onset. We observed a 4-fold increase in patients who were eligible for and treated with tissue plasminogen activator. The tissue plasminogen activator treatment rate for ischemic stroke patients increased from 9.5% to 23.4% (P=0.01), and one in 2 patients with ischemic stroke arriving within 2.5 hours received thrombolysis during this period (one in 5 of patients with ischemic stroke overall). The median onset-to-needle time for tissue plasminogen activator-treated patients was significantly reduced. Many implementation challenges were identified and addressed. CONCLUSIONS: This prehospital triage was immediately successful in improving tissue plasminogen activator access for patients with ischemic stroke, enabling our center to achieve one of the highest tissue plasminogen activator treatment rates in North America and underscoring the need for coordinated systems of acute stroke care. Sustainability of such an initiative will be dependent on interdisciplinary teamwork, ongoing paramedic training, adequate hospital staffing, bed availability, and repatriation agreements with community hospitals. E-publication ahead of print, Stroke, 2009, Oct 29. Go to the abstract here. September 24, 2009 Maximizing tPA Administration: A Discussion This call will feature presentations from Kamakshi Lakshminarayan, MD, Principal Investigator for the Paul Coverdell National Acute Stroke Registry Project in Minnesota, Arshad Majid, MD and Jody Short, MD from Sparrow Healthcare Systems. Speaker presentations will be available to download approximately 1 week prior to the call at http://glrsn.uic.edu. This teleconference is free. Date: Thursday, October 8, 2009 Time: Noon Central/1PM Eastern Presentation Time: Approximately 45 minutes Discussion Time: Approximately 15 minutes Dial in number: 1-888-566-5912 Pass code: GWTG Recommended audience: ED physicians, neurologists, attendings, residents, nursing, ED staff Learning Objectives: Upon completion of this call, participants will be able to: Discuss the studies about extending the window for tPA Explain how hospitals can maximize their tPA administration in rapidly improving cases, mild cases with low NIHSS scores, and patients 90+. Describe how a hospital can increase tPA administration. Visit http://glrsn.uic.edu to register. Participants must register and include the required information, participate on the call and complete the online evaluation. Please familiarize yourself with the contact hours requirements handout. Questions? Angela Bray Hedworth at hedworth@uic.edu. September 2, 2009 Approaches to Swallow Screening: Part Two This call will feature a presentation from Angela Bray Hedworth, MS, RHEd, CHES from The Great Lakes Regional Stroke Network, Marylou Mitchell RN, MSN, Stroke CNS, and Brooke Frommeyer, MA, CCC-SLP from Sparrow Healthcare Systems. Angela will be presenting on various swallow screens found in the literature as well as findings of the GLRSN dysphagia work group. Marylou and Brooke will be presenting how to develop a swallow screen policy. Speaker presentations will be available to download approximately 1 week prior to the call at http://glrsn.uic.edu. This teleconference is free. NO CONTACT HOURS ARE AVAILABLE. Date: Thursday, September 10, 2009 Time: Noon Central/1PM Eastern Presentation Time: Approximately 45 minutes Discussion Time: Approximately 15 minutes Dial in number: 1-800-640-9765 Pass code: 25200006 Host: Angela Hedworth, UIC Dept. of Neurology Recommended audience: Speech language pathologists, nursing, stroke center coordinators, quality improvement Learning Objectives: Upon completion of this call, participants will be able to: - List and briefly describe stroke swallow screens discussed in the literature - Explain the GLRSN initiative for swallow screening - Describe how to develop a swallow screen process To Register: Visit http://glrsn.uic.edu Participants must register and include the required information, participate on the call and complete the online evaluation. Questions? Angela Bray Hedworth at hedworth@uic.edu August 20, 2009 We would like to welcome three new hospitals to the Minnesota Stroke Registry: Regina Medical Center (Hastings), Sanford Tracy Medical Center (Tracy), and Tri-County Hospital (Wadena). Over the next few weeks we will be orienting them and getting them going on data collection starting in September. Welcome! August 16, 2009 Sue Wehner has agreed to repeat her presentation on Swallow Screens due to the technical difficulties experienced on 8/13/09. Please note the different dial-in number and passcode. The time will still be at NOON CENTRAL/1PM EASTERN. I would strongly encourage that you dial in several minutes early to accommodate the large numbers of participants. Date: Thursday, August 20, 2009 Time: Noon Central/1PM Eastern Presentation Time: Approximately 45 minutes Discussion Time: Approximately 15 minutes Dial in number: (800) 640-9765 (NOTE: USE THIS PHONE NUMBER!) Pass code: 25209547 August 12, 2009 The Great Lakes Regional Stroke Network is pleased to partner with Stroke Survivors Empowering Each Other (SSEEO) in offering free teleconferences for stroke survivors and caregivers. Please share this information with your stroke support groups, stroke survivors and caregivers. All calls are free of charge. Medicare Part D, Tuesday, Sep 22, 12:00-1:00 CT Stroke Survivors Inspiring Each Other, Tuesday, Nov 17, 12:00-1:00 CT Putting Your Affairs in Order, Tuesday, Jan 19, 12:00-1:00 CT Safety Pros & Cons of Prescription Medications with Over the Counter Medications, Tuesday, Mar 16, 12:00-1:00 CT Stroke as Depicted in the Movies and Media, Tuesday, May 16th, 12:00-1:00 CT People may register by email at info@sseeo.org or on the website, www.sseeo.org or by calling Christine at 1-800-677-5481 ext. 7438. August 3, 2009 New Google Groups for MSR QI Interest Group and MSR Data Interest Group The MSR program has launched two new discussion groups - one for stroke quality improvement and another for data collection. For information about how to join either, download materials from the QI Corner page. Approaches to Swallow Screening: Part One You are invited to attend a teleconference entitled, "Approaches to Swallow Screening: Part One." This call will feature a presentation from Sue Wehner, PhDc, APRN, BC from Michigan State University. Sue is a Disease Specific reviewer for The Joint Commission's Primary Stroke Center Disease Certification. Speaker presentation will be available to download approximately 1 week prior to the call at http://glrsn.uic.edu. This teleconference is free. Nursing & Occupational Therapist contact hours & Speech Language Pathologist clock hours may be available. Date: Thursday, August 13, 2009 Time: Noon Central/1PM Eastern Presentation Time: Approximately 45 minutes Discussion Time: Approximately 15 minutes Dial in number: 866-620-3971 Pass code: 5641793 NEW: Download the presentation slides here (pdf, 265 kb) posted 8/11/09 Recommended audience: Speech language pathologists, nursing, stroke center coordinators, quality improvement Learning Objectives: Upon completion of this call, participants will be able to: - Describe evidence behind assessment for dysphagia - List TJC guidelines re: dysphagia - Describe ongoing assessment and process of care related to dysphagia Visit http://glrsn.uic.edu to register. Participants must register and include the required information, participate on the call and complete the online evaluation. Please familiarize yourself with the contact hours requirements handout. Questions? Angela Bray Hedworth at hedworth@uic.edu. July 28, 2009 We have released a new document outlining the MSR quality improvement technical assistance services and programs. Please visit the Quality Improvement Corner page for more details. July 14, 2009 The Institute for Clinical Systems Improvement (ICSI) has published its new stroke guidelines and order sets. These are available for free to use. Health Care Guidelines: Diagnosis and Treatment of Ischemic Stroke (7/2009) Order Set: Admission for Ischemic Stroke for Patients not Receiving tPA (7/2009) Order Set: Admission for Ischemic Stroke for Patients Receiving tPA (7/2009) June 2009 The American Association of Neuroscience Nurses has recently released clinical practice guidelines, "Guide to the Care of the Hospitalized Patient with Ischemic Stroke 2nd Edition". These guidelines can be downloaded free of charge from their website at http://www.aann.org/pubs/guidelines.html. There is a short online anonymous download request form before you can download the guidelines. May 2009 Stroke Coding Issues: Barry Libman, MS, RHIA, CCS, CCS-P - President, Barry Libman Inc. Thursday, May 21, 2009, 9-10 am CT Coders and other medical professionals requiring an understanding of the rules specific to the coding of stroke care will benefit from this presentation:how coding captures an episode of medical care; coding rules and guidance that determine the reporting of diagnoses; coding rules specific to stroke; Present on Admission indicators; the future of coding: ICD-10-CM/PCS - Download the Presentation Slides (.ppt, 115 kb) - Listen to the audio presentation by going to the CDC Paul Coverdell National Acute Stroke Registry website. - Download the written transcript of this call (.pdf, 68 kb)

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