title: Cooperative efforts improve compliance with acute stroke guidelines.
abstract: OBJECTIVE
  Guidelines for emergency treatment of stroke are not always known or followed. Florida Medical Quality Assurance, Inc. collaborated with hospitals to determine how closely the current American Heart Association (AHA) and the Florida Agency for Health Care Administration (AHCA) guidelines were being followed and to improve compliance with these guidelines.
  
  
  METHODS
  Medical records of patients admitted for acute stroke to 32 hospitals were retrospectively reviewed for compliance with six quality indicators (QIs) on the basis of AHA and AHCA guidelines. Hospitals were provided feedback on their levels of guideline compliance, and they subsequently implemented measures to improve compliance. After 6 months, the records of patients admitted after the provision of feedback were reviewed for compliance with the same six QIs.
  
  
  RESULTS
  Compliance improved with regard to all QIs and was statistically significant for three of them.
  
  
  CONCLUSIONS
  Feedback on performance, coupled with proactive collaboration with emergency department staff, resulted in improved compliance with the stroke guidelines.
authors.affiliation: Florida Medical Quality Assurance, Inc., Tampa, FL 33607-4151, USA.
authors.forename: Erfan A
authors.initials: EA
authors.lastname: Albakri
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Richards
authors.forename: Marie
authors.initials: M
authors.lastname: Hall
authors.forename: Charles
authors.initials: C
authors.lastname: Dion
authors.forename: Luis S
authors.initials: LS
authors.lastname: Miranda
authors.forename: Robert
authors.initials: R
authors.lastname: Turkel
authors.forename: Charles
authors.initials: C
authors.lastname: Sand
authors.forename: Paulette
authors.initials: P
authors.lastname: Vasey
authors.forename: Kathie
authors.initials: K
authors.lastname: McDonald
authors.forename: Mark
authors.initials: M
authors.lastname: Michelman
authors.forename: Zaid
authors.initials: Z
authors.lastname: Smith
authors.forename: Karen
authors.initials: K
authors.lastname: Davison
authors.forename: Lisa
authors.initials: L
authors.lastname: Pfannerstill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004638:Emergency Treatment / Q000592:standards*; D005246:Feedback; D005260:Female; D005431:Florida; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*