Recommendations for improving the quality of care through stroke centers and systems: an examination of stroke center identification options: multidisciplinary consensus recommendations from the Advisory Working Group on Stroke Center Identification Options of the American Stroke Association.

Robert Adams, Joe Acker, Mark Alberts, Liz Andrews, Richard Atkinson, Kathy Fenelon, Anthony Furlan, Meighan Girgus, Katie Horton, Richard Hughes, Walter Koroshetz, Richard Latchaw, Ellen Magnis, Marc Mayberg, Arthur Pancioli, Rose Marie Robertson, Tim Shephard, Rene Smith, Sidney C. Smith, Suzanne SmithSteven K. Stranne, Edgar J. Kenton, Gil Bashe, Altagracia Chavez, Larry Goldstein, Richard Hodosh, Cindy Keitel, Margaret Kelly-Hayes, Anne Leonard, Lewis Morgenstern, Jack Owen Wood

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: The American Stroke Association (ASA) assembled a multidisciplinary group of experts to develop recommendations regarding the potential effectiveness of establishing an identification program for stroke centers and systems. "Identification" refers to the full spectrum of models for assessing and recognizing standards of quality care (self-assessment, verification, certification, and accreditation). A primary consideration is whether stroke center identification might improve patient outcomes. METHODS: In February 2001, ASA, with the support of the Stroke Council's Executive Committee, decided to embark on an evaluation of the potential impact of stroke center identification. HealthPolicy R&D was selected to prepare a comprehensive report. The investigators reported on models outside the area of stroke, ongoing initiatives within the stroke community (such as Operation Stroke), and state and federal activities designed to improve care for stroke patients. The investigators also conducted interviews with thought leaders in the stroke community, representing a diverse sampling of specialties and affiliations. In October 2001, the Advisory Working Group on Stroke Center Identification developed its consensus recommendations. This group included recognized experts in neurology, emergency medicine, emergency medical services, neurological surgery, neurointensive care, vascular disease, and stroke program planning. RESULTS: There are a variety of existing identification programs, generally falling within 1 of 4 categories (self-assessment, verification, certification, and accreditation) along a continuum with respect to intensity and scope of review and consumption of resources. Ten programs were evaluated, including Peer Review Organizations, trauma centers, and new efforts by the National Committee on Quality Assurance and the Joint Commission on the Accreditation of Healthcare Organizations to identify providers and disease management programs. The largest body of literature on clinical outcomes associated with identification programs involves trauma centers. Most studies support that trauma centers and systems lead to improved mortality rates and patient outcomes. The Advisory Working Group felt that comparison to the trauma model was most relevant given the need for urgent evaluation and treatment of stroke. The literature in other areas generally supports the positive impact of identification programs, although patient outcomes data have less often been published. In the leadership interviews, participants generally expressed strong support for pursuing some form of voluntary identification program, although concerns were raised that this effort could meet with some resistance. CONCLUSIONS: Identification of stroke centers and stroke systems competencies is in the best interest of stroke patients in the United States, and ASA should support the development and implementation of such processes. The purpose of a stroke center/systems identification program is to increase the capacity for all hospitals to treat stroke patients according to standards of care, recognizing that levels of involvement will vary according to the resources of hospitals and systems.

Original languageEnglish (US)
JournalStroke; a journal of cerebral circulation
Volume33
Issue number1
StatePublished - 2002

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Quality of Health Care
Consensus
Stroke
Trauma Centers
Identification (Psychology)
Accreditation
Certification
Standard of Care
Voluntary Programs
Professional Review Organizations
Research Personnel
Joint Commission on Accreditation of Healthcare Organizations
Interviews
Emergency Medicine

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Recommendations for improving the quality of care through stroke centers and systems : an examination of stroke center identification options: multidisciplinary consensus recommendations from the Advisory Working Group on Stroke Center Identification Options of the American Stroke Association. / Adams, Robert; Acker, Joe; Alberts, Mark; Andrews, Liz; Atkinson, Richard; Fenelon, Kathy; Furlan, Anthony; Girgus, Meighan; Horton, Katie; Hughes, Richard; Koroshetz, Walter; Latchaw, Richard; Magnis, Ellen; Mayberg, Marc; Pancioli, Arthur; Robertson, Rose Marie; Shephard, Tim; Smith, Rene; Smith, Sidney C.; Smith, Suzanne; Stranne, Steven K.; Kenton, Edgar J.; Bashe, Gil; Chavez, Altagracia; Goldstein, Larry; Hodosh, Richard; Keitel, Cindy; Kelly-Hayes, Margaret; Leonard, Anne; Morgenstern, Lewis; Wood, Jack Owen.

In: Stroke; a journal of cerebral circulation, Vol. 33, No. 1, 2002.

Research output: Contribution to journalArticle

Adams, R, Acker, J, Alberts, M, Andrews, L, Atkinson, R, Fenelon, K, Furlan, A, Girgus, M, Horton, K, Hughes, R, Koroshetz, W, Latchaw, R, Magnis, E, Mayberg, M, Pancioli, A, Robertson, RM, Shephard, T, Smith, R, Smith, SC, Smith, S, Stranne, SK, Kenton, EJ, Bashe, G, Chavez, A, Goldstein, L, Hodosh, R, Keitel, C, Kelly-Hayes, M, Leonard, A, Morgenstern, L & Wood, JO 2002, 'Recommendations for improving the quality of care through stroke centers and systems: an examination of stroke center identification options: multidisciplinary consensus recommendations from the Advisory Working Group on Stroke Center Identification Options of the American Stroke Association.', Stroke; a journal of cerebral circulation, vol. 33, no. 1.
Adams, Robert ; Acker, Joe ; Alberts, Mark ; Andrews, Liz ; Atkinson, Richard ; Fenelon, Kathy ; Furlan, Anthony ; Girgus, Meighan ; Horton, Katie ; Hughes, Richard ; Koroshetz, Walter ; Latchaw, Richard ; Magnis, Ellen ; Mayberg, Marc ; Pancioli, Arthur ; Robertson, Rose Marie ; Shephard, Tim ; Smith, Rene ; Smith, Sidney C. ; Smith, Suzanne ; Stranne, Steven K. ; Kenton, Edgar J. ; Bashe, Gil ; Chavez, Altagracia ; Goldstein, Larry ; Hodosh, Richard ; Keitel, Cindy ; Kelly-Hayes, Margaret ; Leonard, Anne ; Morgenstern, Lewis ; Wood, Jack Owen. / Recommendations for improving the quality of care through stroke centers and systems : an examination of stroke center identification options: multidisciplinary consensus recommendations from the Advisory Working Group on Stroke Center Identification Options of the American Stroke Association. In: Stroke; a journal of cerebral circulation. 2002 ; Vol. 33, No. 1.
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title = "Recommendations for improving the quality of care through stroke centers and systems: an examination of stroke center identification options: multidisciplinary consensus recommendations from the Advisory Working Group on Stroke Center Identification Options of the American Stroke Association.",
abstract = "BACKGROUND AND PURPOSE: The American Stroke Association (ASA) assembled a multidisciplinary group of experts to develop recommendations regarding the potential effectiveness of establishing an identification program for stroke centers and systems. {"}Identification{"} refers to the full spectrum of models for assessing and recognizing standards of quality care (self-assessment, verification, certification, and accreditation). A primary consideration is whether stroke center identification might improve patient outcomes. METHODS: In February 2001, ASA, with the support of the Stroke Council's Executive Committee, decided to embark on an evaluation of the potential impact of stroke center identification. HealthPolicy R&D was selected to prepare a comprehensive report. The investigators reported on models outside the area of stroke, ongoing initiatives within the stroke community (such as Operation Stroke), and state and federal activities designed to improve care for stroke patients. The investigators also conducted interviews with thought leaders in the stroke community, representing a diverse sampling of specialties and affiliations. In October 2001, the Advisory Working Group on Stroke Center Identification developed its consensus recommendations. This group included recognized experts in neurology, emergency medicine, emergency medical services, neurological surgery, neurointensive care, vascular disease, and stroke program planning. RESULTS: There are a variety of existing identification programs, generally falling within 1 of 4 categories (self-assessment, verification, certification, and accreditation) along a continuum with respect to intensity and scope of review and consumption of resources. Ten programs were evaluated, including Peer Review Organizations, trauma centers, and new efforts by the National Committee on Quality Assurance and the Joint Commission on the Accreditation of Healthcare Organizations to identify providers and disease management programs. The largest body of literature on clinical outcomes associated with identification programs involves trauma centers. Most studies support that trauma centers and systems lead to improved mortality rates and patient outcomes. The Advisory Working Group felt that comparison to the trauma model was most relevant given the need for urgent evaluation and treatment of stroke. The literature in other areas generally supports the positive impact of identification programs, although patient outcomes data have less often been published. In the leadership interviews, participants generally expressed strong support for pursuing some form of voluntary identification program, although concerns were raised that this effort could meet with some resistance. CONCLUSIONS: Identification of stroke centers and stroke systems competencies is in the best interest of stroke patients in the United States, and ASA should support the development and implementation of such processes. The purpose of a stroke center/systems identification program is to increase the capacity for all hospitals to treat stroke patients according to standards of care, recognizing that levels of involvement will vary according to the resources of hospitals and systems.",
author = "Robert Adams and Joe Acker and Mark Alberts and Liz Andrews and Richard Atkinson and Kathy Fenelon and Anthony Furlan and Meighan Girgus and Katie Horton and Richard Hughes and Walter Koroshetz and Richard Latchaw and Ellen Magnis and Marc Mayberg and Arthur Pancioli and Robertson, {Rose Marie} and Tim Shephard and Rene Smith and Smith, {Sidney C.} and Suzanne Smith and Stranne, {Steven K.} and Kenton, {Edgar J.} and Gil Bashe and Altagracia Chavez and Larry Goldstein and Richard Hodosh and Cindy Keitel and Margaret Kelly-Hayes and Anne Leonard and Lewis Morgenstern and Wood, {Jack Owen}",
year = "2002",
language = "English (US)",
volume = "33",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Recommendations for improving the quality of care through stroke centers and systems

T2 - an examination of stroke center identification options: multidisciplinary consensus recommendations from the Advisory Working Group on Stroke Center Identification Options of the American Stroke Association.

AU - Adams, Robert

AU - Acker, Joe

AU - Alberts, Mark

AU - Andrews, Liz

AU - Atkinson, Richard

AU - Fenelon, Kathy

AU - Furlan, Anthony

AU - Girgus, Meighan

AU - Horton, Katie

AU - Hughes, Richard

AU - Koroshetz, Walter

AU - Latchaw, Richard

AU - Magnis, Ellen

AU - Mayberg, Marc

AU - Pancioli, Arthur

AU - Robertson, Rose Marie

AU - Shephard, Tim

AU - Smith, Rene

AU - Smith, Sidney C.

AU - Smith, Suzanne

AU - Stranne, Steven K.

AU - Kenton, Edgar J.

AU - Bashe, Gil

AU - Chavez, Altagracia

AU - Goldstein, Larry

AU - Hodosh, Richard

AU - Keitel, Cindy

AU - Kelly-Hayes, Margaret

AU - Leonard, Anne

AU - Morgenstern, Lewis

AU - Wood, Jack Owen

PY - 2002

Y1 - 2002

N2 - BACKGROUND AND PURPOSE: The American Stroke Association (ASA) assembled a multidisciplinary group of experts to develop recommendations regarding the potential effectiveness of establishing an identification program for stroke centers and systems. "Identification" refers to the full spectrum of models for assessing and recognizing standards of quality care (self-assessment, verification, certification, and accreditation). A primary consideration is whether stroke center identification might improve patient outcomes. METHODS: In February 2001, ASA, with the support of the Stroke Council's Executive Committee, decided to embark on an evaluation of the potential impact of stroke center identification. HealthPolicy R&D was selected to prepare a comprehensive report. The investigators reported on models outside the area of stroke, ongoing initiatives within the stroke community (such as Operation Stroke), and state and federal activities designed to improve care for stroke patients. The investigators also conducted interviews with thought leaders in the stroke community, representing a diverse sampling of specialties and affiliations. In October 2001, the Advisory Working Group on Stroke Center Identification developed its consensus recommendations. This group included recognized experts in neurology, emergency medicine, emergency medical services, neurological surgery, neurointensive care, vascular disease, and stroke program planning. RESULTS: There are a variety of existing identification programs, generally falling within 1 of 4 categories (self-assessment, verification, certification, and accreditation) along a continuum with respect to intensity and scope of review and consumption of resources. Ten programs were evaluated, including Peer Review Organizations, trauma centers, and new efforts by the National Committee on Quality Assurance and the Joint Commission on the Accreditation of Healthcare Organizations to identify providers and disease management programs. The largest body of literature on clinical outcomes associated with identification programs involves trauma centers. Most studies support that trauma centers and systems lead to improved mortality rates and patient outcomes. The Advisory Working Group felt that comparison to the trauma model was most relevant given the need for urgent evaluation and treatment of stroke. The literature in other areas generally supports the positive impact of identification programs, although patient outcomes data have less often been published. In the leadership interviews, participants generally expressed strong support for pursuing some form of voluntary identification program, although concerns were raised that this effort could meet with some resistance. CONCLUSIONS: Identification of stroke centers and stroke systems competencies is in the best interest of stroke patients in the United States, and ASA should support the development and implementation of such processes. The purpose of a stroke center/systems identification program is to increase the capacity for all hospitals to treat stroke patients according to standards of care, recognizing that levels of involvement will vary according to the resources of hospitals and systems.

AB - BACKGROUND AND PURPOSE: The American Stroke Association (ASA) assembled a multidisciplinary group of experts to develop recommendations regarding the potential effectiveness of establishing an identification program for stroke centers and systems. "Identification" refers to the full spectrum of models for assessing and recognizing standards of quality care (self-assessment, verification, certification, and accreditation). A primary consideration is whether stroke center identification might improve patient outcomes. METHODS: In February 2001, ASA, with the support of the Stroke Council's Executive Committee, decided to embark on an evaluation of the potential impact of stroke center identification. HealthPolicy R&D was selected to prepare a comprehensive report. The investigators reported on models outside the area of stroke, ongoing initiatives within the stroke community (such as Operation Stroke), and state and federal activities designed to improve care for stroke patients. The investigators also conducted interviews with thought leaders in the stroke community, representing a diverse sampling of specialties and affiliations. In October 2001, the Advisory Working Group on Stroke Center Identification developed its consensus recommendations. This group included recognized experts in neurology, emergency medicine, emergency medical services, neurological surgery, neurointensive care, vascular disease, and stroke program planning. RESULTS: There are a variety of existing identification programs, generally falling within 1 of 4 categories (self-assessment, verification, certification, and accreditation) along a continuum with respect to intensity and scope of review and consumption of resources. Ten programs were evaluated, including Peer Review Organizations, trauma centers, and new efforts by the National Committee on Quality Assurance and the Joint Commission on the Accreditation of Healthcare Organizations to identify providers and disease management programs. The largest body of literature on clinical outcomes associated with identification programs involves trauma centers. Most studies support that trauma centers and systems lead to improved mortality rates and patient outcomes. The Advisory Working Group felt that comparison to the trauma model was most relevant given the need for urgent evaluation and treatment of stroke. The literature in other areas generally supports the positive impact of identification programs, although patient outcomes data have less often been published. In the leadership interviews, participants generally expressed strong support for pursuing some form of voluntary identification program, although concerns were raised that this effort could meet with some resistance. CONCLUSIONS: Identification of stroke centers and stroke systems competencies is in the best interest of stroke patients in the United States, and ASA should support the development and implementation of such processes. The purpose of a stroke center/systems identification program is to increase the capacity for all hospitals to treat stroke patients according to standards of care, recognizing that levels of involvement will vary according to the resources of hospitals and systems.

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