Get With The Guidelines–Stroke

Get With The Guidelines–Stroke
Name	Get With The Guidelines–Stroke
Founded	2003
Founder	American Heart Association, American Stroke Association
Focus	Stroke care quality improvement
Parent	American Heart Association

Get With The Guidelines–Stroke

Get With The Guidelines–Stroke is a hospital-based quality improvement initiative focused on acute ischemic stroke and hemorrhagic stroke care. The program, administered by the American Heart Association and developed with the American Stroke Association, integrates evidence-based protocols across emergency departments, neurology services, and rehabilitation units. Participating centers include academic medical centers, community hospitals, and regional stroke centers linked to networks such as Mayo Clinic, Cleveland Clinic, and Johns Hopkins Hospital.

Overview

Get With The Guidelines–Stroke provides standardized clinical pathways, performance measures, and data collection tools designed to increase adherence to guidelines produced by professional bodies like the American Academy of Neurology, World Health Organization, and European Stroke Organisation. The initiative parallels other quality campaigns such as Target: Stroke, Get With The Guidelines–Heart Failure, and national registries including the National Institutes of Health initiatives and the Centers for Disease Control and Prevention surveillance efforts. It aligns hospital practices with landmark trials and guidelines influenced by studies from institutions like Harvard Medical School, Stanford University School of Medicine, and University of California, San Francisco.

History and Development

The program was launched in the early 2000s by the American Heart Association and American Stroke Association amid rising attention to stroke systems of care following policy shifts influenced by entities such as the Institute of Medicine and reports from the Agency for Healthcare Research and Quality. Early collaborators included stroke specialists from Massachusetts General Hospital, Barnes-Jewish Hospital, and Brigham and Women's Hospital. Development incorporated evidence from randomized controlled trials at institutions like National Institutes of Health Clinical Center and drew on quality frameworks similar to initiatives by the Joint Commission and datasets used in registries such as Get With The Guidelines–Heart Failure and the Vascular Quality Initiative.

Program Components and Interventions

Core components comprise benchmarks for rapid triage and thrombolytic therapy reflecting criteria evaluated in trials at University of Pittsburgh Medical Center and protocols endorsed by professional societies including the Royal College of Physicians and European Medicines Agency guidance on alteplase. The program promotes measures such as door-to-needle time reduction, acute stroke team activation, dysphagia screening developed with speech pathology groups at Mayo Clinic, and secondary prevention strategies involving antithrombotic and statin therapy paralleling studies at Oxford University Hospitals and Imperial College London. Educational modules involve collaborations with training programs at Columbia University Irving Medical Center, Yale New Haven Hospital, and University of Pennsylvania Health System.

Implementation and Hospital Participation

Hospitals enroll voluntarily and integrate program tools into electronic health records from vendors like Epic Systems Corporation, Cerner Corporation, and Allscripts. Participation often dovetails with certification as a primary or comprehensive stroke center by the Joint Commission, state health departments such as the New York State Department of Health, and regional collaboratives like Get With The Guidelines regional partners. Implementation teams include multidisciplinary personnel from departments at institutions such as Duke University Hospital, UCLA Medical Center, and Toronto General Hospital and coordinate with emergency medical services systems like Los Angeles County EMS and London Ambulance Service.

Outcomes and Evidence of Effectiveness

Peer-reviewed analyses using registry data demonstrate associations with improved process measures and short-term outcomes, mirroring findings from quality-improvement literature involving The Lancet, New England Journal of Medicine, and JAMA. Studies comparing participating sites to non-participating centers reported higher rates of timely thrombolysis and anticoagulation, drawing on datasets linked to Centers for Medicare & Medicaid Services claims and research at University of Michigan Hospitals. Longitudinal reports show reductions in in-hospital mortality and complications consistent with evidence from trials at Karolinska University Hospital and cohort studies from Johns Hopkins Bloomberg School of Public Health.

Quality Metrics and Data Reporting

The program tracks standardized performance measures such as door-to-needle time, antithrombotic therapy by day two, smoking cessation counseling, and discharge on statin therapy, metrics comparable to those used by the National Quality Forum and incorporated into quality reports by organizations like American College of Cardiology and Society of Critical Care Medicine. Data submission supports benchmarking against national aggregates compiled with analytic methods akin to those of the Agency for Healthcare Research and Quality and reporting frameworks used by the Centers for Medicare & Medicaid Services for value-based purchasing and quality payment programs.

Category:Stroke