title: Stroke quality metrics: systematic reviews of the relationships to patient-centered outcomes and impact of public reporting.
abstract: OBJECTIVE
  Stroke quality metrics play an increasingly important role in quality improvement and policies related to provider reimbursement, accreditation, and public reporting. We conducted 2 systematic reviews examining the relationships between compliance with stroke quality metrics and patient-centered outcomes, and public reporting of stroke metrics and quality improvement, quality of care, or outcomes.
  
  
  METHODS
  MEDLINE and EMBASE databases were searched to identify studies that evaluated the relationship between stroke quality metric compliance and patient-centered outcomes in acute hospital settings and public reporting of stroke quality metrics and quality improvement activities, quality of care, or patient outcomes. We specifically excluded studies that evaluated the effect of stroke units or hospital certification.
  
  
  RESULTS
  Fourteen studies met eligibility criteria for the review of stroke quality metric compliance and patient-centered outcomes; 9 found mostly positive associations, whereas 5 found no or very limited associations. Only 2 eligible studies were found that directly addressed the public reporting of stroke quality metrics.
  
  
  CONCLUSIONS
  Some studies have found positive associations between stroke metric compliance and improved patient-centered outcomes. However, high-quality studies are lacking and several methodological difficulties make the interpretation of the reported associations challenging. Information on the impact of public reporting of stroke quality metric data is extremely limited. Legitimate questions remain as to whether public reporting of stroke metrics is accurate, effective, or has the potential for unintended consequences. The generation of high-quality data examining quality metrics and stroke outcomes as well as the impact of public reporting should be given priority.
authors: Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, MI 48824, USA.
authors: Carol
authors: C
authors: Parker
authors: Lee H
authors: LH
authors: Schwamm
authors: Gregg C
authors: GC
authors: Fonarow
authors: Eric E
authors: EE
authors: Smith
authors: Mathew J
authors: MJ
authors: Reeves
mesh_terms: D006801:Humans; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D058996:Quality Improvement; D020521:Stroke / Q000628:therapy*; D016896:Treatment Outcome