Stroke. 2011 Mar;42(3):849-77. doi: 10.1161/STR.0b013e318208eb99. Epub 2011 Jan 13.
Stroke is a major cause of disability and death. The Brain Attack Coalition has proposed establishment of primary and comprehensive stroke centers to provide appropriate care to stroke patients who require basic and more advanced interventions, respectively. Primary stroke centers have been designated by The Joint Commission since 2003, as well as by various states. The designation of comprehensive stroke centers (CSCs) is now being considered. To assist in this process, we propose a set of metrics and related data that CSCs should track to monitor the quality of care that they provide and to facilitate quality improvement.
We analyzed available guideline statements, reviews, and other literature to identify the major features that distinguish CSCs from primary stroke centers, drafted a set of metrics and related data elements to measure the key components of these aspects of stroke care, and then revised these through an iterative process to reach a consensus. We propose a set of metrics and related data elements that cover the major aspects of specialized care for patients with ischemic cerebrovascular disease and nontraumatic subarachnoid and intracerebral hemorrhages at CSCs.
The metrics that we propose are intended to provide a framework for standardized data collection at CSCs to facilitate local quality improvement efforts and to allow for analysis of pooled data from different CSCs that may lead to development of national performance standards for CSCs in the future.
中风是导致残疾和死亡的主要原因。脑卒中国际联盟提出建立初级和综合卒中中心，分别为需要基本和更高级干预措施的中风患者提供适当的治疗。自 2003 年以来，联合委员会以及各个州已经指定了初级卒中中心，现在正在考虑指定综合卒中中心（CSC）。为了协助这一过程，我们提出了一套指标和相关数据，CSC 应跟踪这些指标和数据，以监测其提供的治疗质量，并促进质量改进。
我们分析了现有的指南声明、综述和其他文献，以确定区分 CSC 和初级卒中中心的主要特征，起草了一套指标和相关数据元素，以衡量这些卒中治疗方面的关键组成部分，然后通过迭代过程进行修订，以达成共识。我们提出了一套指标和相关数据元素，涵盖了 CSC 中缺血性脑血管病和非创伤性蛛网膜下腔和脑内出血患者的专科治疗的主要方面。
我们提出的指标旨在为 CSC 提供标准化数据收集的框架，以促进当地的质量改进工作，并允许对来自不同 CSC 的汇总数据进行分析，这可能导致未来为 CSC 制定国家绩效标准。
