Author(s): Amy Markham, MSN, RN, SCRN
QRM Coordinator of Neurology & Emergency Medicine
Augusta Health

My background is primarily in emergency medicine where I began my career in 1999 as an EMT-Intermediate. I enjoyed serving in different roles within EMS and the Virginia Association of Volunteer Rescue Squads. I naturally transitioned to working in the ED where I spent the next 14 years as an EMT and eventually becoming an LPN and then RN. As my career developed, I found myself working in the Quality Department with a focus on Neurology & Emergency Medicine where I established a Sepsis Program and served as the Sepsis Coordinator for 4 years. I have overseen the Stroke Program & quality improvement initiatives for the stroke patients we serve for the past 7 years. where I am responsible for DNV Stroke accreditation, data abstraction, community outreach, collaboration with EMS for education & training. During this time, I have earned both my MSN and SCRN.

Adam Schwartz
Augusta Health

Competency Domain: Population Health & Care Transitions

Description: Every minute that passes by when someone is having a stroke, 1.9 million brain cells are being lost. Recognition of stroke signs and symptoms and calling 911 is the key to minimizing long term affects of stroke and death; therefore patients need to arrive timely within 4.5 hours for treatment. The purpose is to understand health equity variables that impact patient arrival within 4.5 hours of onset of stroke signs and symptoms. By applying a standardized set of health equity variables demonstrates support of CMS Health Equity Strategic Plan and Virginia Statewide Stroke Initiatives.Problem:According to Get with the Guidelines Stroke Registry entered data at Augusta Health, 60% of patients with stroke do not arrive within 4.5 hours to maximize benefit from evidenced based care. Need to understand the barriers of why they are not arriving in time to treat.Measurement:Comparative data with specific variablesAnalysis:Descriptive StatisticsImplementation:Initial challenges included communicating clearly to the Data Science Team to provide requested data in a format for comparison. Implemented analysis with area deprivation index (ADI), mini market service area, and health equity variables including race/ethnicity, gender, age, PCP access.Results/DiscussionOur stroke population is impacted by ADI scores ranging from 6-10. Main age group not arriving in 4.5 hours is 50-64 years old. Approximately half had not seen a PCP in the last 12 months as the area is not well covered by the mobile clinic and access primary care.

Evaluation: Complete Poster Evaluation