Residents at the Detroit Medical Center have helped the system overcome its relatively weak treatment of stroke patients using a watchdog group of residents, financial incentives and a checklist strategy.
In 2013, all four hospitals in the DMC healthcare system were Joint Commission Top Performers, yet not one of the hospitals was considered a top performer in stroke quality measures, with a systemwide composite compliance rate to the measures of 88 percent.
To address the relatively low compliance rates, DMC introduced a 10-item electronic checklist for stroke patients in 2014. Some measures that comprise the checklist include stroke education for patients and giving statins to every discharged patient who had a stroke. The electronic checklist also had timers alongside certain metrics that needed to be completed as soon as possible to ensure compliance.
DMC also chose 14 quality resident directors from across all four hospitals and paid them to supervise stroke quality compliance. The supervisors were charged with tasks such as conducting daily chart reviews and contacting nurses, physicians and other healthcare workers to address the quality measures.
"By getting [residents] so directly involved with patient care and with quality measures, it gives them the opportunity to pursue leadership within the infrastructure of the health system," said Marissa Dean, MD, a study author and neurology resident at the Detroit Medical Center affiliated with Wayne State University School of Medicine, also in Detroit.
Six months after the program was implemented, stroke quality measure compliance jumped to 96.5 percent and, by December 2014, compliance levels were at 100 percent.
The findings of the DMC stroke quality study were presented recently at the American Academy of Neurology meeting.
More articles on stroke care:
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