Stroke Clinical Measures

DNV Comprehensive Stroke Center

CoxHealth is certified as a DNV Comprehensive Stroke Center (CSC). Comprehensive Stroke Centers represent the most advanced stroke treatment available in a geographic area.

DNV GL's stroke certification programs incorporate elements from our NIAHO® hospital accreditation standards, as well as requirements from the Guidelines of the Brain Attack Coalition and Recommendations of the American Stroke Association.

The emphasis these programs place on deploying a disciplined management system, combined with the relevant clinical best practices, sets DNV GL stroke certifications apart from other programs.

GWTG = Get With The Guidelines, STK = stroke measure set, t-PA = tissue plasminogen activator, VTE = venous thromboembolism

Get With The Guidelines® (GWTG) is the premier hospital-based quality improvement program for the American Heart Association and the American Stroke Association, empowering health care provider teams to consistently treat stroke patients using current evidence-based guidelines. CoxHealth uses the GWTG aggregate comparative data for internal quality improvement, as well as for comparison to other Comprehensive Stroke Centers throughout the nation.

Door-to-Needle Explanation

Target: Stroke, launched by the American Heart Association/American Stroke Association in 2010, is a national quality improvement initiative focused on improving acute ischemic stroke care by reducing door-to-needle times for eligible patients being treated with tPA.

The benefits of tPA in patients with acute ischemic stroke are time-dependent, and guidelines recommend a door-to-needle time of 60 minutes or less. However, studies have found that less than 30 percent of U.S. patients are treated within this window.

Target: Stroke goals have been updated in order to continue to focus on door-to-needle times, as well as endovascular therapy door-to-puncture times.

Target: Stroke aims to continue to reduce door-to-needle times for eligible patients being treated with tPA by establishing more aggressive goals for participating hospitals. The goals for Target: Stroke are:

  • Primary Goal: Achieve door-to-needle times within 60 minutes in 85 percent or more of acute ischemic stroke patients treated with IV tPA.
  • Secondary Goal: Achieve door-to-needle times within 45 minutes in 75 percent or more of acute ischemic stroke patients treated with IV tPA.
  • Achieve door-to-needle times within 30 minutes in 50 percent or more of acute ischemic stroke patients treated with IV tPA.