title: Benchmarks for acute stroke care delivery.
abstract: OBJECTIVE
  Despite widespread interest in many jurisdictions in monitoring and improving the quality of stroke care delivery, benchmarks for most stroke performance indicators have not been established. The objective of this study was to develop data-derived benchmarks for acute stroke quality indicators.
  
  
  METHODS
  Nine key acute stroke quality indicators were selected from the Canadian Stroke Best Practice Performance Measures Manual.
  
  
  METHODS
  A population-based retrospective sample of patients discharged from 142 hospitals in Ontario, Canada, between 1 April 2008 and 31 March 2009 (N = 3191) was used to calculate hospital rates of performance and benchmarks.
  
  
  METHODS
  The Achievable Benchmark of Care (ABC™) methodology was used to create benchmarks based on the performance of the upper 15% of patients in the top-performing hospitals.
  
  
  METHODS
  Benchmarks were calculated for rates of neuroimaging, carotid imaging, stroke unit admission, dysphasia screening and administration of stroke-related medications.
  
  
  RESULTS
  The following benchmarks were derived: neuroimaging within 24 h, 98%; admission to a stroke unit, 77%; thrombolysis among patients arriving within 2.5 h, 59%; carotid imaging, 93%; dysphagia screening, 88%; antithrombotic therapy, 98%; anticoagulation for atrial fibrillation, 94%; antihypertensive therapy, 92% and lipid-lowering therapy, 77%. ABC™ acute stroke care benchmarks achieve or exceed the consensus-based targets required by Accreditation Canada, with the exception of dysphagia screening.
  
  
  CONCLUSIONS
  Benchmarks for nine hospital-based acute stroke care quality indicators have been established. These can be used in the development of standards for quality improvement initiatives.
authors.affiliation: Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, G wing, G-106, Toronto, Ontario, M4N 3M5, Canada. ruth.hall@ices.on.ca.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Hall
authors.forename: Ferhana
authors.initials: F
authors.lastname: Khan
authors.forename: Mark T
authors.initials: MT
authors.lastname: Bayley
authors.forename: Eriola
authors.initials: E
authors.lastname: Asllani
authors.forename: Patrice
authors.initials: P
authors.lastname: Lindsay
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Christina
authors.initials: C
authors.lastname: O'Callaghan
authors.forename: Frank L
authors.initials: FL
authors.lastname: Silver
authors.forename: Moira K
authors.initials: MK
authors.lastname: Kapral
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001583:Benzoxazoles; D005260:Female; D006801:Humans; D008297:Male; D019984:Quality Indicators, Health Care / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards; D020521:Stroke / Q000453:epidemiology / Q000628:therapy*
chemical_list: D001583:Benzoxazoles; C090950:ontazolast
keywords: benchmarking; measurement of quality; quality improvement; quality management