title: Compliance with joint commission measures in state-designated stroke centers.
abstract: BACKGROUND
  Comparison of state-designated primary and comprehensive stroke centers (PSCs and CSCs) with regard to adherence to nationally accepted performance standards are scarce. The objective of this study was to examine if a significant association exists between level of designation and fulfillment of Joint Commission (JC) stroke core measures.
  
  
  METHODS
  A retrospective comparative data analysis of the New Jersey acute stroke registry for the calendar years 2010 and 2011 was performed. JC core measures were compared by hospital level (PSCs vs CSCs). Adjusted odds ratios (aOR) were estimated for association between hospital levels and fulfillment of JC core measures. Median door-to-thrombolytic time was also compared.
  
  
  RESULTS
  There were 36,892 acute stroke admissions. PSCs had 60% of the patients, whereas CSCs had 40%. Hemorrhagic stroke admissions were about 2 times more frequent at CSCs than PSCs (13.3% and 7.1%, respectively). CSCs adhered better to 6 of the 8 JC measures than PSCs. Of eligible patients, 19.5% received thrombolytic therapy at CSCs compared to 9.6% at PSCs, with a 44% difference in provision of thrombolytic therapy (aOR = 0.28, 95% confidence interval: 0.24-0.34). Median door-to-thrombolytic drug times was 65 minutes at CSCs compared to 74.0 minutes at PSCs (P < 0.0001).
  
  
  CONCLUSIONS
  New Jersey state-designated CSCs are better at adhering to the JC core stroke measures and have shorter door-to-thrombolytic drug times.
authors: New Jersey Neuroscience Institute, Edison, JFK Medical Center, New Jersey.
authors: Spozhmy
authors: S
authors: Panezai
authors: Tefera
authors: T
authors: Gezmu
authors: Jawad
authors: J
authors: Kirmani
authors: Florence
authors: F
authors: Chukwuneke
authors: Ratna
authors: R
authors: Bitra
authors: Abate
authors: A
authors: Mammo
authors: Martin
authors: M
authors: Gizzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000592:standards*; D016208:Databases, Factual / Q000592:standards; D005260:Female; D006801:Humans; D007591:Joint Commission on Accreditation of Healthcare Organizations; D008297:Male; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D061665:Time-to-Treatment / Q000592:standards*; D014481:United States / Q000453:epidemiology