Background: Intracerebral hemorrhage (ICH) accounts for 10% of strokes and is the most fatal subtype. Unlike ischemic stroke, adoption of quality metrics for ICH has lagged. The 90-day modified Rankin Score (mRS) measures functional outcomes, but its use in ICH patients is rarely reported or tracked as a hospital outcome measure. Objective: The American Heart Association (AHA) convened a learning collaborative with twenty-two Comprehensive Stroke Centers over three years to improve ICH data collection, increase 90-day mRS capture, and develop implementation strategies for national amplification. Methods: The learning collaborative met bimonthly to exchange model share ideas, templated workflows, EHR enhancements and internal justification toolkits developed to increase 90-day mRS data capture. Key clinicians were identified and trained in obtaining an accurate mRS. Information regarding a follow-up phone call was provided at patient discharge to strengthen engagement. Get With The Guidelines® (GWTG)-Stroke data registry was utilized for patient list generation, tracking timely follow-up phone calls and patient outcomes. Results: Implementation activations were associated with a nearly 3-fold improvement in collection of 90-day mRS outcomes across learning collaborative sites. Key strategies included notifying patients of upcoming follow-up calls at discharge, using a shared templated “dot” phrase to standardize EHR documentation, and conducting follow-up calls that not only assessed functional outcome but also facilitated referrals to rehabilitation, neurology clinics, and medication management. Disseminating learning collaborative insights nationally will drive broader impact and advance widespread adoption of 90-day mRS outcome tracking.
Abelt et al. (Thu,) studied this question.