Abstract WP320: Stroke Recovery Across the Plains: A Collaborative Initiative in Rural Post-Acute Care

Introduction: Post-acute care (PAC) facilities across Montana, Nebraska, and North Dakota participated in the American Heart Association’s (AHA) Tri-State Mission: Lifeline Stroke PAC Initiative, a quality improvement initiative focused on improving stroke rehabilitation across Midwest states from 2022 to 2024. Participating facilities agreed to implement evidence-based practice outlined by AHA’s PAC Stroke Program Standards. Purpose: The Tri-State Mission: Lifeline Stroke PAC Initiative aimed to assist facilities to implement evidenced-based care and track key performance measures and outcome metrics to facilitate ongoing quality improvement. 15 skilled nursing facilities, 7 inpatient rehabilitation facilities, and 15 critical access hospitals participated across three states with emphasis on developing programs in rural communities. Methods: Participating facilities collected quarterly data for six clinical measures and three outcome metrics detailed in the PAC stroke program standards. Data was entered on the Quality and Certification Tool (QCT) platform to track progress and compare to other sites in the initiative. Group data was reviewed with facilities each quarter on virtual learning collaboratives. Results: Positive improvements were reported in four measures: percentage of patients with aphasia receiving speech therapy, patients receiving comprehensive stroke education, patients with impaired mobility who are on a VTE prophylaxis plan, and patients receiving a phone call within 3 business days of discharge. Performance remained consistent in two measures: percentage of patients receiving a depression screening and patients that had an admission assessment completed by an MD or APP in the first 24 hours. Outcome metrics of average length of stay, number of patients, and discharge disposition remained consistent. Conclusion: Focused quality improvement efforts can positively impact key measures and metrics in post-acute stroke programs. While positive trends were observed in four measures, further evaluations need to be done with larger patient volumes and extended periods of time.