Table 2

Topics and findings of selected major publications

Schwamm 200542 Recommendations from the ASA Task Force to establish stroke systems to improve patient outcomes in the prevention, treatment and rehabilitation of stroke in the USA.
Reeves 20059 Results from four PCNASR pilot prototypes showed a minority of acute stroke patients are treated according to established guidelines.
Schwamm 200614 Requirements for the design and implementation of a sustainable national registry for stroke quality improvement.
Schwamm  200918 Implementation of GWTG is associated with increased adherence to all stroke performance measures regardlesss of hospital size, geography and teaching status.
Schwamm 20105 A presidential advisory from the AHA/ASA reviewing a decade of efforts to reduce death and disability due to stroke.
Schwamm 2010107 Quality of care improved for black, white and Hispanic patients in GWTG hospitals, though black patients still received fewer evidence-based care processes.
Fonarow  201015 Analysis of the first 1 million stroke and TIA admissions in GWTG showed improvements in quality of care, length of stay and inhospital mortality over time.
Smith 201087 Development of a risk score for inhospital ischaemic stroke mortality derived and validated within the GWTG programme.
Fonarow  201150 Fewer than one-third of patients treated with IV tPA had DTN times ≤60 min. Provided some of the first evidence that shorter DTN times were associated with improved outcomes and greater safety, calling for a targeted initiative to improve timeliness of reperfusion.
Lewis  201125 Use of anticoagulation among stroke patients with atrial fibrillation increased to very high levels in GWTG hospitals.
Reeves  201121 Improvements in quality care associated with the GWTG programme were related to better care rather than better data documentation.
Reeves  201219 Comparison of patient and hospital characteristics among Medicare beneficiaries hospitalised with ischaemic stroke showed GWTG stroke admissions are representative of the national Medicare stroke population.
Messé  201248 Use of tPA between 3 and 4.5 hours increased after publication of the ECASS III in GWTG hospitals.
Fonarow  201289 Adding stroke severity as measured by the NIHSS improved model discrimination for hospital 30-day mortality.
Saver  201354 Earlier thrombolytic treatment was associated with reduced mortality and symptomatic intracranial haemorrhage and higher rates of independent ambulation at discharge and discharge to home.
Schwamm  201366 GWTG hospitals saw nearly doubled tPA administration from 2003 to 2011 with expansion to include more patients with mild symptoms, non-white race/ethnicity and older age.
Ellrodt  201317 GWTG improves the value of care through rapid and sustained improvements in quality, narrowing the treatment gaps for women, younger and older patients and ethnic/racial minorities.
Fonarow  201465 DTN times for tPA administration and clinical outcomes after stroke improved significantly after implementation of the Target: Stroke quality improvement initiative.
Cronin 201474 Patients meeting ECASS III exclusion criteria are often treated in the 3–4.5 hour window without worse outcomes.
Xian 201539 Warfarin treatment was associated with improved clinical outcomes among stroke patients with atrial fibrillation.
Reeves  201530 Documentation of NIHSS has improved in GWTG hospitals but is higher for patients who are thrombolysis candidates.
Song 201631 Medicare beneficiaries in GWTG hospitals had improved functional outcomes at discharge and reduced postdischarge mortality compared with their matched counterparts in unaffiliated hospitals.
  • AHA/ASA, American Heart Association/American Stroke Association; DTN, door-to-needle; GWTG, Get With the Guidelines; IV TPA, intravenous tissue plasminogen activator; NIHSS, National Institutes of Health Stroke Scale; PCNASR, Paul Coverdell National Acute Stroke Registry.