Comparison of performance achievement award recognition with primary stroke center certification for acute ischemic stroke care.
Abstract
BACKGROUND: Hospital certification and recognition programs represent 2 independent
but commonly used systems to distinguish hospitals, yet they have not been directly
compared. This study assessed acute ischemic stroke quality of care measure conformity
by hospitals receiving Primary Stroke Center (PSC) certification and those receiving
the American Heart Association's Get With The Guidelines-Stroke (GWTG-Stroke) Performance
Achievement Award (PAA) recognition. METHODS AND RESULTS: The patient and hospital
characteristics as well as performance/quality measures for acute ischemic stroke
from 1356 hospitals participating in the GWTG-Stroke Program 2010-2012 were compared.
Hospitals were classified as PAA+/PSC+ (hospitals n = 410, patients n = 169,302),
PAA+/PSC- (n = 415, n = 129,454), PAA-/PSC+ (n = 88, n = 26,386), and PAA-/PSC- (n
= 443, n = 75,565). A comprehensive set of stroke measures were compared with adjustment
for patient and hospital characteristics. Patient characteristics were similar by
PAA and PSC status but PAA-/PSC- hospitals were more likely to be smaller and nonteaching.
Measure conformity was highest for PAA+/PSC+ and PAA+/PSC- hospitals, intermediate
for PAA-/PSC+ hospitals, and lowest for PAA-/PSC- hospitals (all-or-none care measure
91.2%, 91.2%, 84.3%, and 76.9%, respectively). After adjustment for patient and hospital
characteristics, PAA+/PSC+, PAA+/PSC-, and PAA-/PSC+ hospitals had 3.15 (95% CIs 2.86
to 3.47); 3.23 (2.93 to 3.56) and 1.72 (1.47 to 2.00), higher odds for providing all
indicated stroke performance measures to patients compared with PAA-/PSC- hospitals.
CONCLUSIONS: While both PSC certification and GWTG-Stroke PAA recognition identified
hospitals providing higher conformity with care measures for patients hospitalized
with acute ischemic stroke, PAA recognition was a more robust identifier of hospitals
with better performance.
Type
Journal articleSubject
Primary Stroke Center certificationacute stroke
measures registry
Achievement
Acute Disease
Aged
Aged, 80 and over
Awards and Prizes
Brain Ischemia
Certification
Female
Hospitals
Humans
Male
Middle Aged
Quality of Health Care
Stroke
Permalink
https://hdl.handle.net/10161/15018Published Version (Please cite this version)
10.1161/JAHA.113.000451Publication Info
Fonarow, Gregg C; Liang, Li; Smith, Eric E; Reeves, Mathew J; Saver, Jeffrey L; Xian,
Ying; ... GWTG-Stroke Steering Committee & Investigators (2013). Comparison of performance achievement award recognition with primary stroke center
certification for acute ischemic stroke care. J Am Heart Assoc, 2(5). pp. e000451. 10.1161/JAHA.113.000451. Retrieved from https://hdl.handle.net/10161/15018.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Adrian Felipe Hernandez
Duke Health Cardiology Professor
Eric David Peterson
Fred Cobb, M.D. Distinguished Professor of Medicine
Dr Peterson is the Fred Cobb Distinguished Professor of Medicine in the Division of
Cardiology, a DukeMed Scholar, and the Past Executive Director of the Duke Clinical
Research Institute (DCRI), Durham, NC, USA.
Dr Peterson is the Principal Investigator of the National Institute of Health, Lung
and Blood Institute (NHLBI) Spironolactone Initiation Registry Randomized Interventional
Trial in Heart Failure With Preserved Ejection Fraction (SPIRRIT) Trial He is also
the Principal I
This author no longer has a Scholars@Duke profile, so the information shown here reflects
their Duke status at the time this item was deposited.
Ying Xian
Adjunct Associate Professor in the Department of Neurology
Alphabetical list of authors with Scholars@Duke profiles.

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