Standardized Documentation Improves Stroke Guideline Compliance (57)

Objective: To improve institutional compliance with national stroke measures by adopting standardized EHR documentation for use by neurology residents. Background: Primary stroke center programs collect and report 9 inpatient measures developed by the Joint Commission and AHA/ASA. At academic institutions, the large number of neurology residents at varying levels of training presents a challenge in compliance with these measures. Standardizing EHR documentation to address these core measures may help increase compliance by prompting residents to address each measure in a step-by-step fashion. Design/Methods: Standardized EHR documentation templates were created encompassing core measures as outlined by the Joint Commission: VTE prophylaxis, discharge on antithrombotic, discharge on anticoagulation, antithrombotic by hospital day two, discharge on statin, dysphagia screening, stroke education, smoking cessation counseling, and rehabilitation assessment. Data was collected via chart abstraction for 301 inpatient stroke hospitalizations. Results: Standardized documentation resulted in improved compliance with many of the core inpatient measures, with dramatic improvement seen in measures of receiving antithrombotic by hospital day two (average monthly compliance improved from 88.63% to 94.13%), dysphagia screening (72.4% to 84.45%), and stroke education (81.82% to 88.67%). Conclusions: Standardized EHR documentation templates appear to mitigate issues of inconsistency in the management of stroke patients at academic institutions. In this particular case, these improvements contributed toward the institution gaining Comprehensive Stroke Center certification. Improved compliance with core inpatient measures may improve outcomes of patient safety and understanding of stroke and its contributory comorbidities. Further studies may be done to evaluate improved outcomes as a result of improved documentation, as well as evaluating the benefit of other EHR tools. Disclosure: Dr. Etter has nothing to disclose. Dr. Dawod has nothing to disclose. Dr. Kafka has nothing to disclose. Dr. Scherer has nothing to disclose.