Using key performance indicator monitoring to improve medical care quality for ischemic cerebral vascular disorders

Aim:To observe the role of key performance indicators(KPI) monitoring in improving the medical care quality for patients with ischemic stroke or transient ischemic attack(TIA).Methods: KPI were setup according to Medical Care Quality Control for Cerebral Infarction by National Ministry of Health and the Get With The Guideline(GWTG)-Stroke program by America Heart Association/ America Stroke Association,and the KPI monitoring has been begun for all in-patients with acute ischemic stroke or TIA since March 2010 in our department.The stroke-registry databank from 2006-2007 of our hospital was used for historical controls,and the data was compared also with that of GWTG-Stroke program in USA and Taiwan,respectively.Results: From March 2010 to February 2012,565 in-patients were enrolled.As compared with the ischemic stroke historical data,the thrombolysis rate for patients who arrived at hospital within 2 h after the onset increased from 28.6% to 50.0%(P=0.009),for those who arrived at hospital within 3.5 h after the onset increased from 31.6% to 36.2%(P=0.703) after using KPI monitoring.Significant improvements were achieved in deep vein thrombosis prophylaxis,use of lipid-lowering drug,smoking cessation,dysphagia screening,health education and rehabilitation(each P0.01).However,there was still a gap between the KPI data we achieved as compared with that of GWTG-stroke program of the United States in 2009,although better than that of Taiwan GWTG-stroke program in 2008.For patients with TIA,we achieved also significant improvements in smoking cessation,lipid-lowering drug(each P0.05) and slightly improvements in other KPIs.Conclusion:The quality of medical care for patients with ischemic stroke or transient ischemic attack can be improved by KPI monitoring.Continuing improvement of medical care quality is needed while the gap still exists as compared with the performance of USA.