Abstract WP177: Stroke Success, Simplified: Standardizing Resources Across All Levels of Care

Background: There are significant rural-urban and level of stroke center inequities in stroke care and outcomes. Our organization has a unique geographical area with 83% of our hospitals (10/12) located in rural Southeastern North Dakota and North and Central Minnesota. This results in most stroke coordinators within our organization assuming numerous care roles. Standardized practices and resources can improve patient-centered care, foster quicker problem-solving techniques, encourage connections, and support disseminating expert stroke knowledge and promote best practice. Purpose: Timely, best practice stroke care, along with staff engagement and satisfaction is most important to improve positive patient outcomes. The focus of this quality improvement initiative was optimizing best practice, patient care, and reducing staff workload in all stroke levels of care. Methods: Utilizing the American Heart Association/American Stroke Association scientific statements and a learning collaborative model; 12 hospitals (1 CSC, 1 TSC, 1 PSC, and 9 ASRC), including administrative leadership teams were engaged. Monthly virtual performance improvement sessions are held to discuss action plans, identify trends, and develop a Plan Do Study Act. Results: In 2018, all twelve certified stroke programs were functioning independently. Significant gaps included; lack of standardized orders, policies, documentation, patient, family, and staff resources. After implementation by tertiary stroke centers, the number of organizational orders (28 to 4) and policies (13 to 2) decreased with 100% standardization. Patient and family resources enhanced 100% with standardization of patient education (3 to 1). Community stroke support increased with virtual options (2 to 12 sites). All stroke online learning modules were standardized enhancing staff education (100%). Electronic Health Record (EHR) stroke documentation improved with standardized documentation available at all hospitals. Conclusion: A framework is necessary to build the foundational relationship between stroke programs within an organization to positively impact stroke patient care, outcomes, and staff workload. Standardizing stroke care amongst all stroke levels of care ensures all patients receive best practice care. Developing a organizational stroke system of care has shown to improve work relations, enhance connections, and decrease workload.