title: Implementing a state-based stroke quality improvement collaborative: the Massachusetts experience.
abstract: BACKGROUND
  The Stroke Collaborative Reaching for Excellence is a voluntary stroke quality improvement (QI) collaborative led by a partnership between the Massachusetts Department of Public Health and the American Heart Association/American Stroke Association. Since 2005, the collaborative has assisted Massachusetts Primary Stroke Service hospitals in improving the quality of acute stroke care based on national clinical guidelines. We provide a general overview for states seeking to establish a public-private partnership to promote hospital stroke QI.
  
  
  METHODS
  Based on the Institute for Healthcare Improvement's Collaborative model, the program enrolled hospitals, trained staff in data collection, and provided expertise on clinical QI. To assess the success of the model at engaging hospitals, rates of change in participation and case entry were calculated with descriptive statistics.
  
  
  RESULTS
  From 2005 to 2010, 58 of 70 (83%) Primary Stroke Service hospitals participated in the collaborative, accounting for over 85% of the statewide annual stroke discharges. On average, 74% of hospital representatives attended learning sessions, 55% participated in data quality conference calls, and 54% attended regional meetings. Over 39,000 cases were entered into the registry from 2007 to 2010, with a 15% increase from 2007 (mean, 171 ± 136; n = 9425) to 2010 (mean, 197 ± 143; n = 10,809).
  
  
  CONCLUSIONS
  Consistent participation and case entry confirm that a voluntary state-based hospital QI collaborative is feasible and sustainable. This occurred in the absence of continued hospital funding. Further research is needed to identify the relationship between program participation and improved patient care and the generalizability of the model.
authors: Massachusetts Department of Public Health, Heart Disease and Stroke Prevention and Control, Boston, USA.
authors: H June
authors: HJ
authors: O'Neill
authors: Laura J
authors: LJ
authors: Coe
authors: Zainab
authors: Z
authors: Magdon-Ismail
authors: Lee H
authors: LH
authors: Schwamm
mesh_terms: D000572:American Heart Association; D003299:Cooperative Behavior; D019983:Guideline Adherence; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008404:Massachusetts; D011635:Public Health Administration; D055818:Public-Private Sector Partnerships; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D020521:Stroke / Q000628:therapy*; D014481:United States