2020
Impact of Emergency Department Crowding on Delays in Acute Stroke Care
Jaffe T, Goldstein J, Yun B, Etherton M, Leslie-Mazwi T, Schwamm L, Zachrison K. Impact of Emergency Department Crowding on Delays in Acute Stroke Care. Western Journal Of Emergency Medicine 2020, 21: 892-899. PMID: 32726261, PMCID: PMC7390586, DOI: 10.5811/westjem.2020.5.45873.Peer-Reviewed Original ResearchConceptsAcute stroke careStroke careED crowdingEndovascular therapyConsecutive acute ischemic stroke patientsCare deliveryAcute ischemic stroke patientsGroin puncture timeGuidelines-Stroke registryStroke care deliveryHealth Stroke ScaleIschemic stroke patientsMultiple clinical factorsUrban academic EDInitial stroke severityHigh ED utilizationSingle-institution analysisAcute care deliveryEmergency stroke careOutcomes of interestWilcoxon rank sum testEmergency department (ED) crowdingRank sum testAlteplase deliveryDTN timeAcute ischemic stroke: improving access to intravenous tissue plasminogen activator
Turner A, Schwamm L, Etherton M. Acute ischemic stroke: improving access to intravenous tissue plasminogen activator. Expert Review Of Cardiovascular Therapy 2020, 18: 277-287. PMID: 32323590, DOI: 10.1080/14779072.2020.1759422.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic stroke patientsIschemic strokeStroke patientsTreatment windowAcute ischemic stroke patientsIntravenous tissue plasminogen activatorTreatment ratesUnknown symptom onsetAcute stroke careTissue plasminogen activatorQuality improvement initiativesHealth care resourcesUnited States FoodStroke outcomeSymptom onsetStroke careStroke specialistsStroke systemsTelestroke networkDrug AdministrationAlteplasePatientsPlasminogen activatorStates Food
2018
International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program
Wangqin R, Laskowitz D, Wang Y, Li Z, Wang Y, Liu L, Liang L, Matsouaka R, Saver J, Fonarow G, Bhatt D, Smith E, Schwamm L, Bettger J, Hernandez A, Peterson E, Xian Y. International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program. Journal Of The American Heart Association 2018, 7: e010623. PMID: 30371291, PMCID: PMC6474951, DOI: 10.1161/jaha.118.010623.Peer-Reviewed Original ResearchConceptsChina National Stroke RegistryNational Stroke RegistryAcute ischemic strokeStroke RegistryIschemic strokeChinese patientsDeep venous thrombosis prophylaxisHealth Stroke ScaleVenous thrombosis prophylaxisAcute stroke careAdministration of thrombolyticsEvidence-based guidelinesAmerican Heart AssociationQuality of careBackground AdherenceDischarge antithromboticsThrombosis prophylaxisCessation counselingStroke ProgramStroke ScaleClinical characteristicsHospital arrivalNeedle timePatient characteristicsSecondary prevention
2015
National stroke registries for monitoring and improving the quality of hospital care: A systematic review
Cadilhac D, Kim J, Lannin N, Kapral M, Schwamm L, Dennis M, Norrving B, Meretoja A. National stroke registries for monitoring and improving the quality of hospital care: A systematic review. International Journal Of Stroke 2015, 11: 28-40. PMID: 26763018, DOI: 10.1177/1747493015607523.Peer-Reviewed Original ResearchConceptsStroke careNational strokePatient outcomesNational Stroke RegistryAcute stroke careEvidence-based careHospital-based strokeStroke RegistryNational registryHospital careInitial keyword searchRegistrySystematic reviewPatient consentData linkagePotential papersSystematic searchMost registriesCareStrokeOutcomesBetter awarenessRoutine monitoringCurrent useBetter accessPerception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke
Lin C, Cox M, Olson D, Britz G, Constable M, Fonarow G, Schwamm L, Peterson E, Shah B. Perception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke. Journal Of The American Heart Association 2015, 4: e001298. PMID: 26201547, PMCID: PMC4608060, DOI: 10.1161/jaha.114.001298.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAttitude of Health PersonnelBrain IschemiaDelivery of Health CareDrug Administration ScheduleFemaleFibrinolytic AgentsGuideline AdherenceHealth Care SurveysHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedPerceptionPractice Guidelines as TopicPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareRegistriesStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsTissue plasminogen activatorIntravenous tissue plasminogen activatorAcute ischemic strokeAcute stroke careMinutes of arrivalLow annual volumeEligible patientsGuidelines hospitalsTPA administrationIschemic strokeStroke outcomeStroke careThrombolytic therapySmall percentageUS hospitalsDifferent hospitalsHospitalPatientsPlasminogen activatorTelephone surveyOne-thirdAdministrationMinutesAnnual volumePercentageTelestroke
Rubin M, Demaerschalk B, Schwamm L, Wechsler L. Telestroke. 2015, 47-57. DOI: 10.1007/978-1-4939-2349-6_5.Peer-Reviewed Original ResearchSecondary preventionStroke careHealth Stroke Scale scoreMajor public health problemStroke Scale scoreAcute ischemic strokeAcute stroke carePrimary stroke centerAcute stroke evaluationPrevention of complicationsEducation of patientsPublic health problemPrehospital emergency medical systemEmergency medical systemExcellent interrater agreementStroke practiceStroke providersTelestroke modelIschemic strokeStroke centersStroke evaluationCerebrovascular diseaseEvidence-based practicePoststroke outcomesBedside assessment
2014
Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis
Morris S, Hunter R, Ramsay A, Boaden R, McKevitt C, Perry C, Pursani N, Rudd A, Schwamm L, Turner S, Tyrrell P, Wolfe C, Fulop N. Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis. The BMJ 2014, 349: g4757. PMID: 25098169, PMCID: PMC4122734, DOI: 10.1136/bmj.g4757.Peer-Reviewed Original ResearchConceptsAcute stroke servicesAcute stroke careHospital stayHyperacute careStroke servicesStroke careHospital Episode Statistics databaseSymptoms of strokePatient-level dataSignificant declineIschemic strokeHospital admissionStayPatientsAbsolute reductionMortalityStrokeMortality dataCareStatistics databaseMonth periodGreater ManchesterAdmissionDaysRisk
2013
Impact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model
Hunter R, Davie C, Rudd A, Thompson A, Walker H, Thomson N, Mountford J, Schwamm L, Deanfield J, Thompson K, Dewan B, Mistry M, Quoraishi S, Morris S. Impact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model. PLOS ONE 2013, 8: e70420. PMID: 23936427, PMCID: PMC3731285, DOI: 10.1371/journal.pone.0070420.Peer-Reviewed Original ResearchConceptsAcute stroke careHyper-acute stroke unitLength of stayStroke careStroke patientsReduced hospital lengthAcute stroke patientsNational time trendsDecision analytic modelHospital lengthPatient characteristicsStroke RegisterStroke unitClinical outcomesSpecialist careLocal hospitalPatientsSurvival rateComparative effectivenessCost outcomesSurvival analysisStayTotal cost savingsMortalityCare
2012
Implementing a State-based Stroke Quality Improvement Collaborative
O’Neill H, Coe L, Magdon-Ismail Z, Schwamm L. Implementing a State-based Stroke Quality Improvement Collaborative. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2012, 11: 114-122. PMID: 22825531, DOI: 10.1097/hpc.0b013e31825e12a6.Peer-Reviewed Original ResearchConceptsStroke quality improvementService hospitalsAmerican Heart Association/American Stroke AssociationHealthcare Improvement collaborative modelAcute stroke careAmerican Stroke AssociationNational clinical guidelinesQuality Improvement CollaborativeClinical quality improvementCase entryHospital quality improvementStroke careStroke AssociationClinical guidelinesHospital representativesPatient careStroke dischargesHospitalMassachusetts DepartmentQuality improvementHospital fundingPublic healthConsistent participationDescriptive statisticsCollaborative modelTelestroke increases use of acute stroke therapy
Müller-Barna P, Schwamm L, Haberl R. Telestroke increases use of acute stroke therapy. Current Opinion In Neurology 2012, 25: 5-10. PMID: 22157105, DOI: 10.1097/wco.0b013e32834d5fe4.Peer-Reviewed Original ResearchConceptsTelestroke networkStroke careUsage of guidelinesAcute stroke careAcute stroke therapyIschemic stroke patientsRate of thrombolysisNew therapeutic modalitiesStroke teamAcute strokeNeurological examinationStroke unitStroke patientsStroke therapyStroke managementImproved outcomesTherapeutic modalitiesTelestroke servicesRemote reviewUnderserved areasHigh-quality videoconferencingCareIncrease useRegular basisThrombolysis
2010
Patient-Level and Hospital-Level Determinants of the Quality of Acute Stroke Care
Reeves M, Gargano J, Maier K, Broderick J, Frankel M, LaBresh K, Moomaw C, Schwamm L. Patient-Level and Hospital-Level Determinants of the Quality of Acute Stroke Care. Stroke 2010, 41: 2924-2931. PMID: 20966407, DOI: 10.1161/strokeaha.110.598664.Peer-Reviewed Original ResearchConceptsHospital-level determinantsAcute stroke careQuality of careStroke RegistryStroke carePatient levelPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryAcute Stroke RegistryHospital-level factorsPatient-level factorsHospital-level variablesPatient-level variablesComposite scoreMultilevel linear regression analysesMean composite scoreTIA admissionsHospital factorsIschemic strokeStatus documentationRegistry dataLinear regression analysisHospitalNeurologist involvementSmall hospitalsMeasure for Measure: New Insights Offered and Challenges Encountered in the Efforts to Improve Acute Stroke Care: Comment on “Processes of Care Associated With Acute Stroke Outcomes”
Schwamm L. Measure for Measure: New Insights Offered and Challenges Encountered in the Efforts to Improve Acute Stroke Care: Comment on “Processes of Care Associated With Acute Stroke Outcomes”. JAMA Internal Medicine 2010, 170: 810-812. PMID: 20458089, DOI: 10.1001/archinternmed.2010.93.Peer-Reviewed Original Research
2009
A score to predict early risk of recurrence after ischemic strokeSYMBOLSYMBOL
Ay H, Gungor L, Arsava E, Rosand J, Vangel M, Benner T, Schwamm L, Furie K, Koroshetz W, Sorensen A. A score to predict early risk of recurrence after ischemic strokeSYMBOLSYMBOL. Neurology 2009, 74: 128-135. PMID: 20018608, PMCID: PMC2809031, DOI: 10.1212/wnl.0b013e3181ca9cff.Peer-Reviewed Original ResearchConceptsRecurrent strokeEarly riskPrognostic scoreConsecutive ischemic stroke patientsComprehensive prognostic scoreTIA/strokeAcute stroke careIschemic stroke patientsPredictors of recurrenceRisk of recurrenceCox regression modelEtiologic stroke subtypesPatient management algorithmsBrain infarctsAcute settingIschemic strokeStroke subtypesIndependent predictorsStroke careStroke patientsImaging featuresPrior historySeparate cohortClinical practiceStroke
2008
Stroke Center Designation Can be Achieved by Small Hospitals
Smith E, Dreyer P, Prvu-Bettger J, Abdullah A, Palmeri G, Goyette L, McElligott C, Schwamm L. Stroke Center Designation Can be Achieved by Small Hospitals. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2008, 7: 173-177. PMID: 18791405, DOI: 10.1097/hpc.0b013e318184e2bc.Peer-Reviewed Original ResearchConceptsAcute stroke teamSmall hospitalsStroke teamMassachusetts hospitalsStroke center designationTeaching hospital statusAcute ischemic strokeAcute stroke carePrimary stroke centerMassachusetts DepartmentPublic healthStroke RegistryIschemic strokeStroke centersStroke careStroke servicesCenter designationCare pathwayHospital characteristicsHospital statusTelemedicine consultationsHospitalTomography scanningLarge hospitalsBed size
2006
The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes
Reeves M, Broderick J, Frankel M, LaBresh K, Schwamm L, Moomaw C, Weiss P, Katzan I, Arora S, Heinrich J, Hickenbottom S, Karp H, Malarcher A, Mensah G, Reeves M. The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes. American Journal Of Preventive Medicine 2006, 31: s202-s209. PMID: 17178304, DOI: 10.1016/j.amepre.2006.08.007.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorTissue plasminogen activatorStroke admissionsPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryPlasminogen activatorAcute stroke admissionsAcute Stroke RegistrySmoking cessation counselingPercent of patientsTransient ischemic attackAcute stroke careAcute stroke patientsPercent of admissionsHours of onsetIschemic stroke admissionsHealthcare system levelQuality improvement interventionsYears of ageAntithrombotic treatmentIschemic attackLipid testingStroke RegistryEligible subjectsIschemic stroke
2005
Acute Stroke Care in the US
Reeves M, Arora S, Broderick J, Frankel M, Heinrich J, Hickenbottom S, Karp H, LaBresh K, Malarcher A, Mensah G, Moomaw C, Schwamm L, Weiss P. Acute Stroke Care in the US. Stroke 2005, 36: 1232-1240. PMID: 15890989, DOI: 10.1161/01.str.0000165902.18021.5b.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageFemaleFibrinolytic AgentsGeorgiaHospital RecordsHumansInfusions, IntravenousIschemic Attack, TransientMaleMassachusettsMichiganMiddle AgedOhioPilot ProjectsProspective StudiesQuality ControlRecombinant ProteinsRegistriesRetrospective StudiesStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsRecombinant tissue plasminogen activatorAcute stroke careStroke careStroke admissionsPaul Coverdell National Acute Stroke RegistryIntravenous recombinant tissue plasminogen activatorNational Acute Stroke RegistryHealth care system levelsAcute stroke admissionsAcute Stroke RegistryTransient ischemic attackAcute stroke patientsHours of onsetIschemic stroke admissionsMinutes of arrivalSecondary prevention practicesAge 60 yearsQuality improvement interventionsTissue plasminogen activatorIschemic attackCessation counselingStroke RegistryIschemic strokeIntracerebral hemorrhageStroke patients