The Paul Coverdell National Acute Stroke Registry

Each year more than 700,000 Americans suffer from a stroke; about 25% of them die at the time of the event, or soon after, and 15–30% remain permanently disabled. More than 1 million Americans and their families live with the disabling effects of stroke. The direct and indirect costs of stroke care will  exceed $51 billion in 2007. To help reduce the nation's stroke burden, in addition to efforts to prevent strokes, we need to improve the quality of care provided to patients with acute stroke and thus reduce death and disability from these events. However, a major challenge is that while evidence-based medical guidelines for stroke care have been developed, as well as new and improved diagnostic and treatment tools, many hospitals still do not have the organization, staff, and equipment to effectively diagnose and treat acute stroke patients.

The mission of the Paul Coverdell National Acute Stroke Registry is to

• Measure, track, and improve the quality of care for acute stroke patients;
• Decrease the rate of premature death and disability from acute stroke through secondary prevention;
• Increase public awareness of stroke treatment and prevention; and
• Reduce disparities in acute stroke care by providing underserved populations with better access to such care.

History of the Program

In 2001, Congress charged CDC with implementing state-based registries that measure and track acute stroke care and to use data from the registries in efforts to improve the quality of that care. Congress further directed that this project be named the Paul Coverdell National Acute Stroke Registry, after the late U.S. Senator Paul Coverdell of Georgia, who suffered a fatal stroke in 2000 while serving in Congress.

CDC, in consultation with stroke experts and organizations, piloted eight prototype registry projects, led by academic and medical institutions across the country, to test models for measuring the quality of care delivered to stroke patients. "Wave I" projects, funded in 2001, were located in Georgia, Massachusetts, Michigan, and Ohio. "Wave II" projects, funded in 2002, were located in California, Illinois, North Carolina, and Oregon. These prototype projects gathered data concerning each step of emergency and hospital care for stroke patients, from emergency response to the patients’ eventual discharge from a hospital. At the end of the 3–year pilot period, the results showed that large gaps existed between generally recommended guidelines for treating stroke patients and actual hospital practices. Intensive quality improvement efforts are needed to close those gaps.

In June 2004, CDC provided funds to the state health departments of Georgia, Illinois, Massachusetts, and North Carolina to establish statewide Coverdell stroke registries for acute care hospitals in their states. The purpose of these registries was to develop and implement systems for collecting data on acute stroke care provided to patients, analyzing the collected data, and using the results of those analyses to guide quality improvement interventions at the hospital level through partnerships with hospital doctors, stroke-care teams, and administrators. All acute care hospitals serving the general population in participating states were eligible for the program.

In the first year of program activities states established partnerships with leading medical experts, various hospital associations, local affiliates of the American Hospital Association, and other groups interested in improving health care for stroke patients; developed strategies for identifying and recruiting eligible hospitals; selected and implemented customized Web-based data-collection systems for hospital use; and recruited hospitals to participate in the registry. In the second and third years, states reviewed collected data to identify specific areas of need for quality improvement, worked with hospitals to implement quality improvement interventions to improve care, and evaluated progress toward improving statewide acute stroke care and promoting long-term systemic changes in how that care is provided. By the end of the 2004–2007 project period, more than 180 hospitals were participating in a stroke registry and the percentages of total statewide stroke admissions treated by participating hospitals ranged from 40% to 79% among the four states.

In June 2007, CDC expanded funding to six state health departments in Georgia, Massachusetts, Michigan, Minnesota, Ohio, and North Carolina for the Paul Coverdell National Acute Stroke Registry for a new 5-year funding period. Illinois will continue to participate in stroke quality improvement activities and provide information to CDC on its progress. In 2007, CDC also came to an agreement with The Joint Commission’s Primary Stroke Center Certification program and with the American Heart Association/American Stroke Association’s Get With The Guidelines-Stroke program to jointly release a set of standardized stroke performance measures for use by all three programs. This effort will reduce duplication, increase collaboration, and encourage hospitals to participate in one or more of the programs.

The near-term goals of the Paul Coverdell National Acute Stroke Registry program are to

• Increase the number of states with Coverdell stroke registries.

• Develop and disseminate best practices in hospital recruitment and training, data collection, and quality improvement based on lessons learned.

• Encourage the development of statewide systems of care for stroke patients through coordination with emergency medical services and collaboration among statewide partners.

• Communicate with major stakeholders in stroke care to ensure ongoing improvement in the quality of that care.

The long-term goal of this program is to ensure that all Americans receive the highest quality of acute stroke care currently available and to reduce the number of untimely deaths attributable to stroke, prevent stroke-related disability, and prevent stroke patients from suffering recurrent strokes.

Coverdell Stroke Registry Prototypes

Note: The states colored red started participation in the Paul Coverdell Stroke Registry prototypes in September 2001.  The states colored orange started participation in Wave II in May 2002.

Paul Coverdell National Acute Registry States, 2007

Related Information

One or more of the following files are available in Portable Document Format (PDF). Learn more about PDFs.

• Paul Coverdell Acute Stroke Registry Data Elements (PDF–656K)
• Consensus Acute Stroke Performance Measures (PDF–35K)
• American Heart Association*
• American Stroke Association*

 
*Links to non–Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.
 

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Page last reviewed: March 13, 2008
Page last modified: March 13, 2008
Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion