Impact of Local Tailoring on Acute Stroke Care in 21 Disparate Emergency Departments: A Prospective Stepped Wedge Type III Hybrid Effectiveness-Implementation Study.
Kathleen E McKeeAndrew J KnightonKristy VealeJulie MartinezCory McCannJonathan W AndersonDoug WolfeRobert BlackburnMarilyn McKassonTyler BardsleyBlessing S Ofori-AttaTom H GreeneRobert HoeschH Adrian PüttgenRajendu SrivastavaPublished in: Circulation. Cardiovascular quality and outcomes (2024)
A centrally led implementation strategy with local site tailoring led to faster delivery of tPA across disparate EDs in a multihospital system with no change in clinical effectiveness outcomes including rates of complication. Disparities in performance persisted between stroke and nonstroke centers.