Using a quality improvement process to create measurable improvement in care delivery for acute stroke.

The introduction of thrombolytic therapy has revolutionized the management of acute ischemic stroke, and it has now been conclusively established that tissue plasminogen activator (t-PA) given within 4.5 hours of stroke onset both limits irreversible ischemic neuronal damage by establishing reperfusion of the penumbra and improves outcomes for patients who have undergone stroke. As a regional stroke centre, Hamilton Health Services (HHS) seeks to ensure it meets guidelines and readiness criteria in acute stroke care. This article discusses how HHS developed and used a quality improvement process to ensure all patients receive thrombosis therapy within 60 minutes of arrival at hospital.