Table 20-5.
Time Trends in GWTG-Stroke Quality-of-Care Measures, 2006–2009
| Quality of Care Measure | 2006 | 2007 | 2008 | 2009 |
|---|---|---|---|---|
| Thrombolytic complications: IV tPA and life-threatening, serious systemic hemorrhage | 20.8 | 17.3 | 16.1 | 15.1 |
| Antithrombotics <48 h after admission* | 94.8 | 95.8 | 96.0 | 96.2 |
| DVT prophylaxis by second hospital day* | 85.3 | 88.9 | 92.2 | 92.7 |
| Antithrombotics at discharge* | 94.1 | 95.1 | 97.0 | 97.8 |
| Anticoagulation for atrial fibrillation at discharge* | 88.2 | 89.5 | 93.1 | 93.5 |
| Therapy at discharge if LDL >100 mg/dL or LDL not measured or on therapy at admission* | 70.3 | 76.3 | 82.1 | 86.2 |
| Counseling for smoking cessation* | 86.1 | 92.2 | 94.3 | 96.2 |
| Lifestyle changes recommended for BMI >25 kg/m2 | 42.5 | 45.7 | 51.7 | 57.3 |
| Composite quality-of-care measure† | 85.9 | 88.9 | 91.7 | 93.3 |
GWTG indicates Get With The Guidelines; IV, intravenous; tPA, tissue-type plasminogen activator; DVT, deep venous thrombosis; LDL, low-density lipoprotein; BMI, body mass index.
Values are percentages. In-hospital mortality for the 2009 patient population was 6.9%, and mean length of hospital stay was 5.3 days (median 3.0 days).
Indicates key performance measures targeted in GWTG-Stroke.
The composite quality-of-care measure indicates performance on the provision of several elements of care. It is computed by summing the numerators for each key achievement measure across the population of interest to create a composite numerator (all the care that was given), summing the denominators for each measure to form a composite denominator (all the care that should have been given), and reporting the ratio (the percentage of all the needed care that was given).