New Initiative Targets Stroke Treatment in Emergency Rooms

Every 40 seconds someone in the United States experiences a stroke, creating a time-sensitive emergency for nearly 800 thousand people each year. The results can be devastating, including 130,000 deaths every year, making strokes the fifth leading cause of death in Michigan. Strokes are also the leading cause of serious long-term disabilities and generate more than $56 billion in related costs.

The time it takes for a stroke to be diagnosed is a key predictor of outcomes, but patients who make it to an emergency room often face inconsistent treatment across unpredictable timelines. A new collaboration is aimed at improving patient outcomes and experiences by targeting what happens in ERs and the immediate hospitalization period. This initiative aims to save lives and patient functionality, and works to prevent strokes and raise awareness and management of stroke risk factors.

The new partnership

The Michigan Emergency Department Improvement Collaborative, or MEDIC, represents hundreds of physicians, 12 health systems and nearly 70 hospitals using quality improvement to address some of the most common reasons people visit the emergency room, including physical injury, pulmonary embolism, opioid overdose, respiratory illness, and chest pain.

Now MEDIC is expanding its focus by partnering with Michigan Stroke Treatment Improvement Collaborative, or MISTIC, a voluntary collaboration of many primary and comprehensive stroke centers across Michigan.

"The complexity of acute stroke care demands robust partnerships and collaboration,” said Keith Kocher, MD, program director of MEDIC and associate professor at Michigan Medicine. “By joining forces and working together to standardize protocols and share best practices across Michigan, we can ensure that every patient receives timely, high-quality care no matter where they enter the health system."

Connecting MISTIC’s stroke expertise with MEDIC’s trusted network of multidisciplinary care providers and expansive data registry resources will provide new opportunities to implement and evaluate stroke quality improvement initiatives in a timelier manner.

“Speed and consistency in diagnosing and treating strokes can mean the difference between recovery and lifelong disability,” said Aditya Pandey, MD, program director of MISTIC and Michigan Medicine professor. “By connecting the expertise of MISTIC’s stroke centers with MEDIC’s vast network and data resources, we’re creating a pathway for rapid, standardized and evidence-based stroke care for patients across Michigan.”

Improving stroke outcomes

The MEDIC-MISTIC collaboration will focus on improving three key areas of stroke care: early identification of acute stroke patients in the ED for timely treatment in the most appropriate care location including delivery of endovascular procedures (for example, thrombectomy) to remove blood clots from blocked vessels, restoring blood flow to the brain, and ensuring patients receive appropriate treatments and resources upon hospital discharge to reduce the likelihood of a future stroke and long-term disability.

Additional goals for the new collaboration include:

-Establishing consistent, evidence-based recommendations for stroke management across participating centers
-Facilitating the dissemination of best practices to reduce variation and ensure equitable stroke care statewide
-Measuring and improving the quality, safety and cost-effectiveness of stroke treatment
 

The new collaboration is funded by Blue Cross Blue Shield of Michigan as part of its Value Partnerships program.

For more information on the new MEDIC-MISTIC partnership, contact Megan Norris at [email protected].