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Georgia Coverdell Acute Stroke Registry

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Background and Purpose

Named in honor of the late Senator Paul Coverdell of Georgia, who died of a massive stroke in 2000, the primary goal of the Georgia Coverdell Acute Stroke Registry (GCASR) program is to improve the care of acute stroke patients in the hospital and pre-hospital settings. The program is funded by the Centers for Disease Control Paul S. Coverdell National Acute Stroke Registry cooperative agreement and was established in 2001 as a prototype project implemented by the Emory University School of Medicine. Full implementation and incorporation into the State’s Department of Public Health (DPH) began in 2005.

This program addresses quality improvement in multiple areas of stroke care, from rapid screening, diagnosis, and intervention for patients experiencing an acute stroke, to secondary prevention measures such as blood pressure control, smoking cessation, and treatment of elevated cholesterol to reduce the incidence of recurrent stroke after hospital discharge. In addition, the program will also help improve the use of rehabilitation services for those who have experienced an acute stroke, in an effort to reduce long-term disability due to stroke.

States in the southeastern U.S. have the highest incidence and mortality of stroke; as a result, this area of the U.S. is commonly referred to as the stroke belt. In an effort to reduce long-term disability, the GCASR and the State of Georgia Cardiovascular Health Initiative Program work to reduce heart disease-and stroke-related morbidity and mortality in Georgia.

Goals

  • Increase quality improvement through collaborative efforts among participant hospitals and EMS agencies.

  • Lower the stroke morbidity experienced in Georgia.

  • Enhance the effectiveness of secondary care and prevent recurrent strokes.

  • Develop protocols to guide clinical care with effective stroke management.

  • Develop effective methods to care for acute stroke patients.

Participating Hospitals

GCASR initially enrolled 26 hospitals in late 2005. In 2013, 64 participating entities, representing 66 hospitals participate in the registry, which provide a coverage close to 80% of the annual acute stroke admissions in Georgia. GCASR plans to enroll more hospitals in the coming years.

Benefits of the Registry

Benefits for the participating hospitals and EMS agencies, and their patients include:

  • Monthly registry-wide telephone conference calls with participating hospitals, EMS agencies and GCASR staff

  • “Kickoff” workshop for new participants

  • Annual regional data abstraction training workshops

  • Quarterly GCASR newsletters

  • Annual meetings to exchange best practices

  • Quality improvement consultant to work with hospital staff on-site or by telephone

  • Encouragement to hospitals to network with one another

  • Great resources and mentoring for hospitals needing specific stroke related information

  • Georgia Coverdell Champion Hospital of the Year Awards

  • Opportunity to contribute to improve stroke care quality statewide

In addition, training in Advanced Stroke Life Support through the University of Miami’s ASLS Emergency Medical Skills Training Course is provided to hospital and EMS staff. This training teaches emergency assessment and management of acute stroke to all levels of healthcare providers, from Emergency Medical Services personnel to Hospital and Emergency Department nurses and physicians.

The Registry benefits patients directly by offering real-time feedback to hospitals that covers patient-related Quality of Care Indicators. Selected patient care information on each stroke admission is entered into an online data collection tool. Real-time analysis provides feedback to each hospital related to the quality of care that their patients are receiving. Hospitals can also compare their performance on quality indicators with other hospitals using the Get With The Guidelines - Stroke database. Up-to-date guidance on standards of care is provided to caregivers through the online tool as well. In addition, patient education resources, published by the American Stroke Association and by the Georgia Department of Public Health (DPH), are available to the patient or hospital. Improvements in quality of care are tracked regularly by the GCASR and feedback is provided back to the hospitals related to their Quality Indicator performance.

Partners

The Georgia Coverdell Acute Stroke Registry is a partnership among a number of groups and organizations, all of whom have the goal of improving the quality of care of acute stroke patients in Georgia, with the ultimate hope of reducing the deaths and disability due to stroke for all citizens in Georgia. The partners include:

In addition, the Georgia Coverdell Stroke Advisory Sub-Committee, part of the Georgia Stroke Systems of Care Task Force, includes healthcare leaders who are engaged in all aspects of the care of acute stroke patients, acts in an advisory role, and helps to direct the growth of the GCASR as well as maximize its impact throughout the state.

To Participate

If you are interested in having your hospital become a Coverdell Hospital, please contact Kerrie Krompf (Emory University School of Medicine) or James Lugtu (Georgia Department of Public Health, GCASR Quality Improvement Coordinator).

Resources

Guidelines for Early Management of Adults With Ischemic Stroke

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2010 Update

Guidelines for the Primary Prevention of Stroke: 2011 Update

Centers for Disease Control and Prevention, Stroke – Home Page

Centers for Disease Control and Prevention, Heart Disease – Home Page

Behavioral Risk Factor Surveillance System (BRFSS)

A state-based surveillance system that gathers information about knowledge, attitudes, and health behaviors, including those related to stroke risk factors. It is used to track behavior change among populations, determine priority health issues and develop plans to address them, and monitor the effectiveness of interventions. Data are available for Georgia state-wide as well as by Health District.

Live Healthy Georgia Campaign

This Campaign is designed to raise awareness and provide education about the prevention of chronic diseases and the promotion of healthy behaviors.

Brain Attack Coalition

The Brain Attack Coalition is a group of professional, voluntary, and governmental entities dedicated to reducing the occurrence, disabilities, and death due to stroke. This site provides professional resources for systems development for stroke care and pathways for the rapid diagnosis and treatment of acute stroke, as well as links to patient resources that provide helpful information to stroke patients, their families, and their caregivers.