Get With The Guidelines Stroke Rural Recognition Criteria

Award Recognition for Rural Hospitals

The American Heart Association recognizes that rural hospitals work with varied patient care dynamics. For that reason, all rural hospitals participating in Get With The Guidelines Stroke, Heart Failure or Coronary Artery Disease, whether involved in the Rural Health Care Outcomes Accelerator or not, are eligible to receive award recognition focused on a unique set of performance metrics:

Recognition Criteria Breakdown

Overall Rural Stroke Composite Score: Percentage of performance opportunities that were met among eligible care opportunities the 10 individual rural acute stroke measures.

  • Door To CT < = 25min - Percentage of Ischemic stroke, TIA, Subarachnoid hemorrhage, Intracerebral hemorrhage, or Stroke not otherwise specified patients who receive brain imaging initiation within 25 minutes of hospital arrival.
  • Documentation of Last Known Well or Time of Discovery of Stroke Symptoms- Percentage of Ischemic stroke, Subarachnoid hemorrhage, Intracerebral hemorrhage, or Stroke not otherwise specified patients for whom a time Last Known Well (LKW) or Time of Discovery of Stroke Symptoms was documented.
  • Door-in-Door-Out Time at First Hospital Prior to Transfer for Acute Therapy -Percentage of confirmed Ischemic stroke patients for whom <= 90 minutes was spent in the ED prior to transfer to a higher-level stroke center (e.g. PSC, CSC, etc.) for time-critical therapy
  • Dysphagia Screen- Percent of Ischemic stroke, Subarachnoid hemorrhage, Intracerebral hemorrhage, or Stroke not otherwise specified patients who undergo screening for dysphagia with an evidence-based bedside testing protocol approved by the hospital before being given any food, fluids, or medication by mouth or remained NPO throughout the entire hospital stay.
  • IV Thrombolytic Arrive by 3.5 Hour, Treat by 4.5 Hour - Percent of acute Ischemic stroke patients who arrive at the hospital within 210 minutes (3.5 hours) of time last known well and for whom IV thrombolytic was initiated at this hospital within 270 minutes (4.5 hours) of time last known well
  • NIHSS Reported - Percent of Ischemic stroke and stroke not otherwise specified patients with a score reported for NIH Stroke Scale (Initial)
  • Non-Contrast Brain CT or MRI Interpreted within 45 Minutes from Presentation - Percent of Ischemic stroke patients with documentation of CT or MRI brain imaging interpretation within 45 minutes of presentation
  • Pre-notification- Percent of Ischemic Stroke, TIA, Subarachnoid Hemorrhage, Intracerebral Hemorrhage or Stroke not otherwise specified patients who were transported to your hospital by EMS or MSU from scene who received advanced notification by EMS of an incoming suspected stroke patient.
  • Telestroke Consultation Done- Percentage of Ischemic stroke, Subarachnoid hemorrhage, Intracerebral hemorrhage, or Stroke not otherwise specified patients who received a Telestroke consultation.
  • Time to Intravenous Thrombolytic Therapy - 60 min- Percent of acute ischemic stroke patients receiving intravenous thrombolytic therapy during the hospital stay who have a time from hospital arrival to initiation of thrombolytic therapy administration (door-to-needle time) of 60 minutes or less.
Written by American Heart Association editorial staff and reviewed by science and medicine advisors.

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Last Reviewed: Aug 10, 2022