Get With the Guidelines-Stroke performance indicators: surveillance of stroke care in the Taiwan Stroke Registry: Get With the Guidelines-Stroke in Taiwan.
BACKGROUND
Stroke is a leading cause of death around the world. Improving the quality of stroke care is a global priority, despite the diverse healthcare economies across nations. The American Heart Association/American Stroke Association Get With the Guidelines-Stroke program (GWTG-Stroke) has improved the quality of stroke care in 790 US academic and community hospitals, with broad implications for the rest of the country. The generalizability of GWTG-Stroke across national and economic boundaries remains to be tested. The Taiwan Stroke Registry, with 30 599 stroke admissions between 2006 and 2008, was used to assess the applicability of GWTG-Stroke in Taiwan, which spends ≈ 1/10 of what the United States does in medical costs per new or recurrent stroke.


RESULTS
Taiwan Stroke Registry, sponsored by the Taiwan Department of Health, engages 39 academic and community hospitals and covers the entire country with 4 steps of quality control to ensure the reliability of entered data. Five GWTG-Stroke performance measures and 1 safety indicator are applicable to assess Taiwan Stroke Registry quality of stroke care. Demographic and outcome figures are comparable between GWTG-Stroke and Taiwan Stroke Registry. Two indicators (early and discharge antithrombotics) are close to GWTG-Stroke standards, while 3 other indicators (intravenous tissue plasminogen activator, anticoagulation for atrial fibrillation, lipid-lowering medication) and 1 safety indicator fall behind. Preliminary analysis shows that compliance with selected GWTG-Stroke guidelines is associated with better outcomes.


CONCLUSIONS
Results suggest that GWTG-Stroke performance measures, with modification for ethnic factors, can become global standards across national and economic boundaries for assessing and improving quality of stroke care and outcomes. GWTG-Stroke can be incorporated into ongoing stroke registries across nations.
Hsieh
Fang-I
FI
School of Public Health, Taipei Medical University, Taipei, Taiwan.
Lien
Li-Ming
LM
Chen
Sien-Tsong
ST
Bai
Chyi-Huey
CH
Sun
Mu-Chien
MC
Tseng
Hung-Pin
HP
Chen
Yu-Wei
YW
Chen
Chih-Hung
CH
Jeng
Jiann-Shing
JS
Tsai
Song-Yen
SY
Lin
Huey-Juan
HJ
Liu
Chung-Hsiang
CH
Lo
Yuk-Keung
YK
Chen
Han-Jung
HJ
Chiu
Hou-Chang
HC
Lai
Ming-Liang
ML
Lin
Ruey-Tay
RT
Sun
Ming-Hui
MH
Yip
Bak-Sau
BS
Chiou
Hung-Yi
HY
Hsu
Chung Y
CY
D000368:Aged; D000572:American Heart Association; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011787:Quality of Health Care / Q000592:standards*; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy*; D013624:Taiwan; D014481:United States