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Using Simple Forms in Hospital Can Improve Stroke Care
Using standardised forms at the time stroke patients are admitted to and discharged from the hospital can improve care, according to a study of California hospitals.
"Care of stroke patients is complicated, and the evidence is growing rapidly,” explained S. Claiborne Johnston, MD, PhD, principal investigator for the study and a neurologist and director of the Stroke Service at University of California, San Francisco. "It's difficult for busy clinicians to keep up with proven best practices, and things can fall through the cracks.”
In an effort to increase the use of these treatments, six California hospitals in the study developed standardised forms for use when stroke patients were admitted to and discharged from the hospital. The treatments include: using a clot-busting treatment within three hours of the start of the stroke; preventive treatment for blood clots in the leg veins; drugs that prevent blood clots from forming within 48 hours of arrival at the hospital and at discharge; cholesterol-lowering drugs at discharge; and smoking cessation counselling.
If the treatment was not used, the forms included boxes to check for acceptable reasons for not using the treatment, such as not using a clot-busting drug for a patient who arrived at the hospital more than three hours after the first symptoms or not using cholesterol-lowering drugs for a patient who already had low cholesterol.
The treatment stroke patients received in the year after the new forms were implemented was compared to the treatment they received in the year before the forms were implemented. During that time, 413 patients were treated in the six hospitals.
Overall, patients were more likely to receive optimal treatment after the forms were implemented than before. Optimal treatment was defined as receiving all of the recommended treatments unless there was an appropriate reason not to receive a treatment.
After the forms were implemented, 63 percent of patients received optimal treatment. In the year before the forms were implemented, 44 percent of patients received optimal treatment.
- American Academy of Neurology (AAN)