title: Compliance with the stroke education performance measure in the Michigan Paul Coverdell National Acute Stroke Registry.
abstract: OBJECTIVE
  Stroke education, 1 of 8 endorsed stroke performance measures, consists of 5 specific subcomponents: risk factors, stroke warning signs, emergency medical service activation, physician follow-up, and discharge medications. We identified predictors of stroke education performance measure compliance in the Michigan Paul Coverdell National Acute Stroke Registry.
  
  
  METHODS
  Data were collected on 9609 acute stroke admissions to 20 registry hospitals during 2008 and 2009. Predictors of measure compliance (delivery of all 5 subcomponents) were determined using multivariable logistic regression.
  
  
  RESULTS
  Overall compliance with the stroke education measure was 61.8% (hospital-level compliance ranged between 16% and 93%). Compliance with individual subcomponents were risk factors (65.5%), stroke warning signs (68.9%), emergency medical service activation (66.8%), physician follow-up (92.9%), and discharge medications (91.5%). Age, gender, stroke subtype, prestroke ambulation, discharge destination, and hospital size were all significant independent predictors of compliance. Stroke education was delivered less often to patients who were ≥ 70 years of age, nonambulatory prestroke, not discharged to home, had transient ischemic attack, or hemorrhagic stroke.
  
  
  CONCLUSIONS
  Only 60% of patients received stroke education consistent with the endorsed performance measures. Strategies to increase stroke education, including the impact of incorporating stroke-specific education measures into hospital care protocols, should be explored.
authors.affiliation: Michigan Department of Community Health, Lansing, MI, USA.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Nickles
authors.forename: Jay
authors.initials: J
authors.lastname: Fiedler
authors.forename: Stacey
authors.initials: S
authors.lastname: Roberts
authors.forename: Sarah
authors.initials: S
authors.lastname: Lyon-Callo
authors.forename: Rochelle
authors.initials: R
authors.lastname: Hurst
authors.forename: Mathew
authors.initials: M
authors.lastname: Reeves
mesh_terms: D000328:Adult; D000368:Aged; D003695:Delivery of Health Care; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010353:Patient Education as Topic; D012042:Registries; D020521:Stroke / Q000175:diagnosis* / Q000517:prevention & control