title: Comparison of performance achievement award recognition with primary stroke center certification for acute ischemic stroke care.
abstract: BACKGROUND
  Hospital certification and recognition programs represent 2 independent but commonly used systems to distinguish hospitals, yet they have not been directly compared. This study assessed acute ischemic stroke quality of care measure conformity by hospitals receiving Primary Stroke Center (PSC) certification and those receiving the American Heart Association's Get With The Guidelines-Stroke (GWTG-Stroke) Performance Achievement Award (PAA) recognition.
  
  
  RESULTS
  The patient and hospital characteristics as well as performance/quality measures for acute ischemic stroke from 1356 hospitals participating in the GWTG-Stroke Program 2010-2012 were compared. Hospitals were classified as PAA+/PSC+ (hospitals n = 410, patients n = 169,302), PAA+/PSC- (n = 415, n = 129,454), PAA-/PSC+ (n = 88, n = 26,386), and PAA-/PSC- (n = 443, n = 75,565). A comprehensive set of stroke measures were compared with adjustment for patient and hospital characteristics. Patient characteristics were similar by PAA and PSC status but PAA-/PSC- hospitals were more likely to be smaller and nonteaching. Measure conformity was highest for PAA+/PSC+ and PAA+/PSC- hospitals, intermediate for PAA-/PSC+ hospitals, and lowest for PAA-/PSC- hospitals (all-or-none care measure 91.2%, 91.2%, 84.3%, and 76.9%, respectively). After adjustment for patient and hospital characteristics, PAA+/PSC+, PAA+/PSC-, and PAA-/PSC+ hospitals had 3.15 (95% CIs 2.86 to 3.47); 3.23 (2.93 to 3.56) and 1.72 (1.47 to 2.00), higher odds for providing all indicated stroke performance measures to patients compared with PAA-/PSC- hospitals.
  
  
  CONCLUSIONS
  While both PSC certification and GWTG-Stroke PAA recognition identified hospitals providing higher conformity with care measures for patients hospitalized with acute ischemic stroke, PAA recognition was a more robust identifier of hospitals with better performance.
authors.affiliation: Division of Cardiology, University of California, Los Angeles, CA.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.forename: Li
authors.initials: L
authors.lastname: Liang
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Reeves
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Saver
authors.forename: Ying
authors.initials: Y
authors.lastname: Xian
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.forename: Lee H
authors.initials: LH
authors.lastname: Schwamm
mesh_terms: D000124:Achievement; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001363:Awards and Prizes; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy*; D002568:Certification; D005260:Female; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D020521:Stroke / Q000209:etiology / Q000628:therapy*
keywords: Primary Stroke Center certification; acute stroke; measures registry