North Carolina Collaborative Acute Stroke Registry:

A Paul Coverdell National Acute Stroke Registry

Current NC Stroke Care Collaborative (NCSCC)

In February, 2007, Congress passed a bill to appropriate $390,000 annual recurring funds to the Stroke Registry. Along with NC, Stroke Registries in MI, MN, and OH were granted 5 years of renewal funding for the period of 2007-2012. The NCSCC is currently in its 3 rd year of the current funding, with a total of 53 hospitals participating in the North Carolina Stroke Care Collaborative (NCSCC), and the goal of adding five new hospitals per year. Since 2006, the number of NCSCC participating hospitals has grown from 35 to 53.

The NCSCC is the only program in NC in which data is collected prospectively; concurrent with care. This process will improve the quality of stroke care by continually promoting compliance with best practice guidelines. Unlike with other programs, NCSCC participating hospitals are able to measure their performance on an ongoing basis, examining their strengths and weaknesses, and identifying ways to improve stroke care in their hospital and county. In addition, the registry's performance measures include the Stroke Measure Set utilized by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) for awarding the Certification of Primary Stroke Center.

Mission of the North Carolina Stroke Care Collaborative:

• To measure, track, and improve the quality of acute stroke care.
• To decrease the death and disability from acute stroke through secondary prevention.
• To increase public awareness of stroke treatment and prevention.
• To reduce the disparities in acute stroke care through increased access to quality acute stroke care.

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.