Table 3.
RE-AIM framework to evaluate the public health impact of TCC Coordinated SBST.
| RE-AIM dimension | Outcomes | Data source |
|---|---|---|
| Reach | • Proportion of Alabama MT patients who undergo TCC Coordinated SBST | • ADPH RESCUE ePCR and LifeTrac database |
| • Differential reach by race, ethnicity, sex, and population density | • ADPH RESCUE ePCR and LifeTrac database | |
| Effectiveness | • Proportion and timeliness of MT for EMS-suspected LVO | • LifeTrac and ADPH REDCap databases |
| • Proportion and timeliness of MT for all confirmed Stroke System LVO | • LifeTrac and ADPH REDCap databases | |
| • Proportion and timeliness of tPA treatment | • LifeTrac and ADPH REDCap databases | |
| • Proportion requiring inter-facility transfer and timeliness of transfer | • LifeTrac and ADPH REDCap databases | |
| • Differential effectiveness by race, ethnicity, sex, and population density | • LifeTrac and ADPH REDCap databases | |
| • Differential effectiveness for patients initially triaged to a non-MTC | • LifeTrac and ADPH REDCap databases | |
| • modified Rankin Scale 3 months after discharge | • ADPH REDCap databases | |
| • County/Regional EMS response times | • ADPH RESCUE ePCR | |
| Adoption | • Proportion of Alabama EMS organizations that participate | • ADPH RESCUE ePCR and LifeTrac database |
| • Proportion of stroke centers participating | • ADPH RESCUE ePCR | |
| Implementation | • Proportion of stroke system patients with TCC-guided EMSA performed by EMS | • LifeTrac database |
| • Proportion of EMS transports triaged past a non-MTC to a MTC when advised | • LifeTrac database | |
| • TCC and stroke center adherence to the region-specific triage plan | • LifeTrac and ADPH REDCap databases | |
| • Differential implementation for rural vs. urban populations | • LifeTrac and ADPH REDCap databases | |
| Maintenance | • Sustained adoption and implementation over time | • LifeTrac and ADPH REDCap databases |
RE-AIM, Reach, Effectiveness, Adoption, Implementation, and Maintenance; TCC, Trauma Communications Center; SBST, Severity-Based Stroke Triage; ADPH, Alabama Department of Public Health; RESCUE ePCR, Recording of Emergency Medical Services Calls and Urgent-care Environment electronic Patient Care Reports; LVO, Large Vessel Occlusion; MT, Mechanical Thrombectomy; EMS, Emergency Medical Service; tPA, tissue Plasminogen Activator; MTC, Mechanical Thrombectomy Center.