A survey of stroke‐related capabilities among a sample of US community emergency departments
Abstract Objectives Most acute stroke research is conducted at academic and larger hospitals, which may differ from many non‐academic (ie, community) and smaller hospitals with respect to resources and consultant availability. We describe current emergency department (ED) and hospital‐level stroke‐r...
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Elsevier
2022-08-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12762 |
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| author | Kori S. Zachrison Latha Ganti Dhruv Sharma Pawan Goyal Marquita Decker‐Palmer Opeolu Adeoye Joshua N. Goldstein Edward C. Jauch Bruce M. Lo Tracy E. Madsen William Meurer John A. Oostema Cindy Mendez‐Hernandez Arjun K. Venkatesh |
| author_facet | Kori S. Zachrison Latha Ganti Dhruv Sharma Pawan Goyal Marquita Decker‐Palmer Opeolu Adeoye Joshua N. Goldstein Edward C. Jauch Bruce M. Lo Tracy E. Madsen William Meurer John A. Oostema Cindy Mendez‐Hernandez Arjun K. Venkatesh |
| author_sort | Kori S. Zachrison |
| collection | DOAJ |
| description | Abstract Objectives Most acute stroke research is conducted at academic and larger hospitals, which may differ from many non‐academic (ie, community) and smaller hospitals with respect to resources and consultant availability. We describe current emergency department (ED) and hospital‐level stroke‐related capabilities among a sample of community EDs participating in the Emergency Quality Network (E‐QUAL) stroke collaborative. Methods Among E‐QUAL‐participating EDs, we conducted a survey to collect data on ED and hospital stroke‐related structural and process capabilities associated with quality of stroke care delivery and patient outcomes. EDs submitted data using a web‐based submission portal. We present descriptive statistics of self‐reported capabilities. Results Of 154 participating EDs in 30 states, 97 (63%) completed the survey. Many were rural (33%); most (82%) were not certified stroke centers. Although most reported having stroke protocols (67%), many did not include hemorrhagic stroke or transient ischemic attack (45% and 57%, respectively). Capability to perform emergent head computed tomography and to administer thrombolysis were not universal (absent in 4% and 5%, respectively). Access to neurologic consultants varied; 18% reported no 24/7 availability onsite or remotely. Of those with access, 48% reported access through telemedicine only. Admission capabilities also varied with patient transfer commonly performed (79%). Conclusion Stroke‐related capabilities vary substantially between community EDs and are different from capabilities typically found in larger stroke centers. These data may be valuable for identifying areas for future investment. Additionally, the design of stroke quality improvement interventions and metrics to evaluate emergency stroke care delivery should account for these key structural differences. |
| format | Article |
| id | doaj-art-6d7bbcfa2c2945bd92b910c2e19d98aa |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-6d7bbcfa2c2945bd92b910c2e19d98aa2025-08-20T01:57:08ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-08-0134n/an/a10.1002/emp2.12762A survey of stroke‐related capabilities among a sample of US community emergency departmentsKori S. Zachrison0Latha Ganti1Dhruv Sharma2Pawan Goyal3Marquita Decker‐Palmer4Opeolu Adeoye5Joshua N. Goldstein6Edward C. Jauch7Bruce M. Lo8Tracy E. Madsen9William Meurer10John A. Oostema11Cindy Mendez‐Hernandez12Arjun K. Venkatesh13Department of Emergency Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USADepartment of Emergency Medicine University of Central Florida Orlando Florida USAAmerican College of Emergency Physicians Irving Texas USAAmerican College of Emergency Physicians Irving Texas USAGenentech South San Francisco California USADepartment of Emergency Medicine Washington University St. Louis Missouri USADepartment of Emergency Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USAMission Health Asheville North Carolina USADepartment of Emergency Medicine Eastern Virginia Medical School/Sentara Norfolk General Hospital Norfolk Virginia USADepartment of Emergency Medicine Warren Alpert Medical School of Brown University Providence Rhode Island USADepartment of Emergency Medicine University of Michigan School of Medicine Ann Arbor Michigan USADepartment of Emergency Medicine Michigan State University East Lansing Michigan USAAmerican College of Emergency Physicians Irving Texas USADepartment of Emergency Medicine Yale School of Medicine New Haven Connecticut USAAbstract Objectives Most acute stroke research is conducted at academic and larger hospitals, which may differ from many non‐academic (ie, community) and smaller hospitals with respect to resources and consultant availability. We describe current emergency department (ED) and hospital‐level stroke‐related capabilities among a sample of community EDs participating in the Emergency Quality Network (E‐QUAL) stroke collaborative. Methods Among E‐QUAL‐participating EDs, we conducted a survey to collect data on ED and hospital stroke‐related structural and process capabilities associated with quality of stroke care delivery and patient outcomes. EDs submitted data using a web‐based submission portal. We present descriptive statistics of self‐reported capabilities. Results Of 154 participating EDs in 30 states, 97 (63%) completed the survey. Many were rural (33%); most (82%) were not certified stroke centers. Although most reported having stroke protocols (67%), many did not include hemorrhagic stroke or transient ischemic attack (45% and 57%, respectively). Capability to perform emergent head computed tomography and to administer thrombolysis were not universal (absent in 4% and 5%, respectively). Access to neurologic consultants varied; 18% reported no 24/7 availability onsite or remotely. Of those with access, 48% reported access through telemedicine only. Admission capabilities also varied with patient transfer commonly performed (79%). Conclusion Stroke‐related capabilities vary substantially between community EDs and are different from capabilities typically found in larger stroke centers. These data may be valuable for identifying areas for future investment. Additionally, the design of stroke quality improvement interventions and metrics to evaluate emergency stroke care delivery should account for these key structural differences.https://doi.org/10.1002/emp2.12762emergency departmentemergency stroke carestroke |
| spellingShingle | Kori S. Zachrison Latha Ganti Dhruv Sharma Pawan Goyal Marquita Decker‐Palmer Opeolu Adeoye Joshua N. Goldstein Edward C. Jauch Bruce M. Lo Tracy E. Madsen William Meurer John A. Oostema Cindy Mendez‐Hernandez Arjun K. Venkatesh A survey of stroke‐related capabilities among a sample of US community emergency departments Journal of the American College of Emergency Physicians Open emergency department emergency stroke care stroke |
| title | A survey of stroke‐related capabilities among a sample of US community emergency departments |
| title_full | A survey of stroke‐related capabilities among a sample of US community emergency departments |
| title_fullStr | A survey of stroke‐related capabilities among a sample of US community emergency departments |
| title_full_unstemmed | A survey of stroke‐related capabilities among a sample of US community emergency departments |
| title_short | A survey of stroke‐related capabilities among a sample of US community emergency departments |
| title_sort | survey of stroke related capabilities among a sample of us community emergency departments |
| topic | emergency department emergency stroke care stroke |
| url | https://doi.org/10.1002/emp2.12762 |
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