North Carolina Collaborative Acute Stroke Registry: A Paul Coverdell National Acute Stroke Registry

Current NC Stroke Registry

In July 2004, the North Carolina Department of Health and Human Services Division of Public Health and University of North Carolina at Chapel Hill received a grant from the CDC to implement the North Carolina Collaborative Stroke Registry. Currently, 35 hospitals participate in the registry and 5 more will be added by June 30, 2006. Data is collected prospectively; concurrent with care. This process will improve the quality of stroke care by continually promoting compliance with best practice guidelines. In addition, the registry's performance measures include the Standard Stroke Measure Set utilized by the Joint Commission on Accreditation of Healthcare Organizations ( JCAHO ) for awarding the Certification of Primary Stroke Center .

Specific Aims for the North Carolina Stroke Registry

1. Identify all patients with acute stroke seen in the emergency department (ED) and inpatient units of Participating North Carolina hospitals for a period of six months per year.
2. Collect data on quality of care indicators concurrent with patient care and transmit these data to a centralized, web-based registry.
3. Promote and support quality improvement activities at each registry site.
4. Assess completeness of patient enrollment, reliability of data collection, and validity of diagnosis for enrolled patients.

Background

Senator Paul Coverdell 1939 - 2000

In 2000, Congress appropriated funds to establish prototypes of the Paul Coverdell National Acute Stroke Registry. The initiative was named in honor of United States Senator Paul Coverdell of Georgia who died of a stroke in July 2000. From June 2002 to June 2004, eight states participated in a Centers for Disease Control and Prevention (CDC) funded program to produce prototypes of the Paul Coverdell National Acute Stroke Registry. This state-level evaluation of acute stroke treatment was used to facilitate the development of a standard, national registry for improving stroke outcomes.

North Carolina Stroke Registry Prototype

As a part of this program, the North Carolina Collaborative Acute Stroke Registry was created to design and pilot test real-time data collection to monitor and evaluate the delivery of care to acute stroke patients. The focus of the registry prototype was on stroke acute care, including:

• Onset of symptoms
• Emergency Medical Services ( EMS )
• Hospital emergency department (ED)
• Diagnostic evaluation
• Use of thrombolytics
• Other acute care
• Referral to rehabilitation services.

North Carolina, along with California, Georgia, Illinois, Massachusetts, Michigan, Ohio, and Oregon tested methods that helped form the basis of the current Coverdell National Acute Stroke Registry programs.