Benchmarks and determinants of adherence to stroke performance measures

Background and Purpose - Develop achievable benchmarks for 9 stroke performance measures ( PM) and to identify organizational factors associated with adherence. Methods - Adherence rates and achievable benchmarks were determined for 9 PM within a study of patients (n = 2294) admitted with acute ischemic stroke at 17 hospitals. Baseline information regarding hospital characteristics and stroke-specific processes of care were collected, and multi-level models were used to test the association of these factors with adherence. Results - Benchmarks were >= 90% for 8 of the 9 PM. After controlling for clustering, only use of standing orders was associated with adherence to PM, including: dysphagia screening, venous thrombosis prophylaxis, consideration of tPA, and provision of educational material. Conclusion - High levels of adherence are achievable for several acute stroke PM. Use of standing orders is associated with adherence to PM requiring immediate action on admission.