Wisconsin Coverdell Stroke Program: Hospitals

Participating Partner Hospitals in the Wisconsin Coverdell Stroke Program receive multiple benefits, such as:

• Free access to stroke BE FAST Bella and Risk Factor Rick community education materials
• The opportunity to network with other hospitals and informally share best practices and how to address common challenges
• Dedicated project leadership
• Development of quarterly concordance agreement reports for each site to ensure your data quality remains high
• Quarterly report cards of quality measures across the continuum of care which provide benchmark groups for comparison and have established goals for each measure to assist in motivating and gauging progress
• Free access to Hemispheres free online stroke education as resources are available
• Member of the Coverdell Hospital Learning Collaborative
• Technical assistance to answer questions regarding stroke care and related activities
• Invitations to stroke education opportunities
• Eligible to receive awards at the annual Performance Improvement Awards
• Recognition on the state stroke program website
• A press release template on being a Coverdell Hospital Partner to use for local publicity

If you are interested in becoming a Coverdell Hospital Partner, complete the Coverdell Hospital Partner Agreement, F-01649 (PDF) and send it to Dot Bluma at dbluma@metastar.com.

Partner hospitals

The long-term outcomes of the Paul Coverdell National Acute Stroke Program are:

1. Increased access to care and improved quality of care for stroke patients
2. Decreased disparities in access to care and quality of care for populations at highest risk for stroke events

The following are Coverdell program strategies to achieve the long-term outcomes:

1. Track, monitor, and assess clinical and social services and support needs measures and referrals across the stroke continuum of care for those who have experienced a stroke, those at the highest risk of stroke due to undiagnosed or uncontrolled hypertension, and to identify health care disparities.
2. Promote the implementation of a team-based care approach across the stroke continuum of care for those who have experienced a stroke and those at the highest risk of stroke, focusing on hypertension prevention, detection, control, and management through the mitigation of barriers to social services and support needs to improve outcomes.
3. Link individuals to community resources and clinical services to support bidirectional referrals, self-management, and lifestyle changes for those who have experienced a stroke and those at the highest risk of stroke and to mitigate barriers to social services and support needs to improve outcomes.

Wisconsin’s participation in the Coverdell Registry is facilitated by the Division of Public Health and MetaStar.

About the registry process

Participating hospitals enter and track stroke data using an online quality improvement tool where data is abstracted for 13 consensus measures. Measures were established by the CDC (Centers for Disease Control and Prevention) in collaboration with The Joint Commission and the American Heart Association/American Stroke Association based on evidence from multiple clinical trials in peer-reviewed journals. These provide the foundation for stroke care quality improvement in Wisconsin:

• Anticoagulation for Atrial Fibrillation/Flutter
• Antithrombotics at Discharge
• Early Antithrombotics
• IV Thrombolytic Arrive by 3.5 Hour, Treat by 4.5 Hour
• Intensive Statin Therapy
• LDL Documented
• NIHSS Reported
• Rehabilitation Considered
• Smoking Cessation
• Stroke Education
• Time to Intravenous Thrombolytic Therapy - 45 minutes
• Time to Intravenous Thrombolytic Therapy - 60 minutes
• VTE Prophylaxis

The Coverdell Learning Collaborative (CLC) meets for 1.5 hours quarterly, either in-person or virtually. The meeting provides members the opportunity to network with fellow stroke coordinators as well as ask questions and share best practices. The meeting consists of:

• Review blinded data across the stroke systems of care (SSoC) to identify areas where efficiency and quality of care can be improved
• Discuss, explore, and share best practices on the role of community health workers and patient navigators in post-discharge care
• Identify and create collaborative quality improvement initiatives for Plan-Do-Study-Act (PDSA) cycles
• Update on EMS practices
• Inform on stroke-related activities at the state level

Attendance is required at three of four (75 percent) of these meetings.

Performance Improvement Program

In support of the ongoing quality improvement efforts of participating hospitals, the CLC analyzes Wisconsin Coverdell Stroke Program aggregated hospital stroke data and discusses evidence-based practices and processes that are involved in achieving sustained high performance.

In September we met virtually via a Zoom meeting which was recorded for those who had a conflict. We acknowledged and celebrated the Stroke Coordinator with the fastest arrival to computerized tomography (CT) completion time. The coordinator shared QI efforts which assisted their site in reaching this high level of performance.

• Fastest time to CT initiation in those stroke patients arriving <4.5 hours from Last Known Well for Q2 2024:
  • Gundersen Moundview Hospital and Clinics

We also acknowledged and supported the seven hospitals with 100% defect-free care within the twelve Coverdell performance measures for Q2 2024.

• Ascension NE Wisconsin - St. Elizabeth Campus
• Ascension SE Wisconsin - Franklin Campus
• Aspirus Ironwood Hospital (Grandview)
• Aspirus Langlade Hospital
• Aspirus Medford Hospital and Clinics, Inc.
• Aurora Medical Center Mount Pleasant
• ProHealth Oconomowoc Memorial Hospital

A PI focus for the CLC is the EMS Pre-notification measure. In Q2 2024 there were 21 hospitals who achieved 100%.

• Aspirus Divine Savior Hospital and Clinics
• Aspirus Iron River Hospital
• Aspirus Ironwood Hospital (Grandview)
• Aspirus Keweenaw Hospital
• Aspirus Riverview Hospital and Clinics
• Aspirus Stevens Point Hospital
• Aurora Medical Center Mount Pleasant
• Bellin Hospital
• Gundersen Moundview Hospital & Clinics
• Howard Young Medical Center (Aspirus)
• Marshfield Medical Center
• Marshfield Medical Center - Eau Claire
• Marshfield Medical Center – Weston
• Mercy Health System
• ProHealth Care Oconomowoc Memorial Hospital
• ProHealth Waukesha Memorial Hospital
• Richland Hospital
• ThedaCare Medical Center- New London
• ThedaCare Medical Center Waupaca
• ThedaCare Regional MC Neenah
• ThedaCare Regional Medical Center - Appleton
   

The SCOW Committee meets quarterly. Any hospital in the state of Wisconsin or surrounding states that has an objective of improving stroke patient outcomes by promoting evidence-based care and quality initiatives may participate. Currently, over 110 hospitals have representation in the SCOW.

The mission of the SCOW is to collaboratively improve the quality of stroke care and prevention in Wisconsin, where the goals are to identify quality improvement needs in the state and recognize a process for measuring and monitoring performance. Attendance in-person or virtually is recommended for Coverdell hospitals.

This forum is a great opportunity to:

• Hear from outside speakers on a variety of stroke topics.
• Learn from others in the areas of data collection, quality improvement initiatives, and stroke systems of care.
• Gain insight on preparing for stroke center certification or recertification.
• Network with stroke coordinator peers throughout Wisconsin.

The Stroke Coordinators of Wisconsin Committee has an advisory council that:

• Provides leadership and oversees progress on meeting SCOW recommendations.
• Develops meeting agendas based on the group’s interest and quality improvement priorities.
• Assists in recruiting speakers.

Articles and guidelines

• The Abstracting Stroke Data That Will Work For All Toolkit, P-02467 (PDF) was developed by the Wisconsin Coverdell Stroke Program and the American Heart Association. The toolkit consists of two mock charts which meets the abstraction training needs for all levels of stroke certification including Acute Stroke Ready, Primary Stroke Center, Thrombectomy Capable, and Comprehensive Stroke Centers.
• Mechanical Thrombectomy for Stroke: A Physician Guide, P-03453 (PDF)
• American Heart Association Stroke Statements and Guidelines
• Success Stories

Videos and conference recordings

• Wisconsin's Training of the National Institutes of Health Stroke Scale
• Telestroke Taskforce Clinician Panel

Process documents

• Follow-Up Call Resource Guide: Bridging Transitions of Care for Stroke Survivors after Hospitalization, P-02601 (PDF)
• Stroke Follow-Up Call Triage Algorithm P-02361 (PDF)
• 911 DTN Process, P-02257 (PDF)
• Abstracting an Accurate Last Known Well, P-02812 (PDF) This document will assist the stroke abstractor in correctly identifying a patient’s last known well time as it can be very difficult, as there are often multiple times documented and coding instructions are complex.
• There is an advanced acute stroke treatment for those meeting certain criteria called mechanical thrombectomy in which trained doctors try and remove a large blood clot in the brain. There are three Mechanical Thrombectomy for Stroke educational resources. The Mechanical Thrombectomy for Stroke: A Physician Guide, P-03453 (PDF) contains guideline recommendations, efficacy of treatment, and points for discussion to assist the emergency department physician in providing a consistent and standardized explanation of the thrombectomy procedure to the patient and/or significant others. The Mechanical Thrombectomy for Stroke: A Patient Guide, P-03453A (PDF) consists of a one-page description of the mechanical thrombectomy procedure with key benefits and main risks. This educational resource is to be given to the patient and/or significant other before a mechanical thrombectomy to assist them in understanding what a mechanical thrombectomy is, and to ensure this education is consistent and standardized . A short video, Mechanical Thrombectomy for Stroke: A Patient Video, has been developed to accompany this document.

Toolkits

• Building Blocks of a Stroke Program Toolkit, P-01141 (PDF)
• Empower People with Knowledge: Community Outreach Stroke Awareness Event Planning Toolkit, P-01861 (PDF)
• Wisconsin Telestroke Toolkit, P-03458 (PDF) – When treating a stroke, every second counts. A lack of coordination and/or strict protocols in hospitals due to limited personnel with stroke experience and/or infrequent stroke cases may hinder the ability of the patient to receive expedited care. These hospitals, which are disproportionately smaller and located in rural underserved areas, may benefit from the use of Telestroke, which offers an opportunity for virtual expert neurological consultation regardless of the patient’s physical location. This Telestroke Toolkit provides guidance on initiating and conducting the process through a text-based document and two videos: a Telestroke Task Force Clinician Panel with experts in the field and a demonstration video on conducting the National Institutes of Stroke Scale via telestroke.
• Speed and Efficiency Toolkit, P-03482 (PDF) - Every second counts when treating a patient afflicted with stroke. Stroke care delivery, and speed at which it can be provided, varies by location, and is impacted by the presence of systematic stroke protocols and personnel with stroke expertise. Hospitals without these resources are often critical access hospitals (CAH), which are disproportionately smaller and rural. This Speed and Efficiency Toolkit will focus on the unique needs of CAH in Wisconsin in the treatment of the acute stroke patient and providing the best care to their communities.

Maps

• Wisconsin Critical Access Hospitals
• Wisconsin Hospitals
• Wisconsin EMS Service Center Locations
• Wisconsin Coverdell Program Hospitals, P-03353c (PDF)
• Drive Time to Coverdell Program Hospitals, P-03353b (PDF)
• Drive Time to Hospital Stroke Centers, P-03353d (PDF)
• Wisconsin Coverdell EMS Service and Hospital Partners, P-03353 (PDF)
• Wisconsin Coverdell Program EMS Services, P-03353a (PDF)

Community stroke education

View all of the Coverdell Stroke Program's stroke education materials the Coverdell Community page.

Stroke Disease Specific Certified (DSC) hospitals

There are two certifying bodies Wisconsin hospitals have utilized to certify their stroke programs. To find which hospitals are certified in stroke, follow these steps:

• Det Norske Veritas (DNV)
  • Click on Search Hospitals. Filter by Certification and Filter by State
    • Acute Stroke Ready (ASR)
    • Primary Stroke Center
    • Comprehensive Stroke Center
• The Joint Commission (TJC) (general information)
  • To find Wisconsin certification levels, open the link to Wisconsin certified hospitals
  • In the "Narrow Results" section in the left margin, scroll to "Advanced Certification" and select the desired stroke certification level

Stroke support groups

If you're looking for a stroke support group, or would like to register yours, please visit the American Stroke Association's Stroke Support Group Finder.

The resources presented on this webpage are a sampling of available materials and do not necessarily constitute an endorsement by the Department of Health Services or the American Heart Association/American Stroke Association.