To increase provider compliance rate in the use of stroke specific discharge instructions (DCI) by 15 % which will provide patients with accurate and practical information at the time of discharge to improve their understanding of stroke. Through this we aim to foster patient engagement in the rehabilitation phase of poststroke care and decrease the risk of recurrent stroke by improving compliance with guideline recommended therapies. 

Stroke is one of the most common causes of long-term disability among older adults in the United States. ºÃÉ«ÏÈÉú, support, skill training, and counseling are the cornerstones of recovery. Recent research has shown that survivors often do not reach rehabilitation goals and that lack of information is a major barrier to continued recovery. Having dedicated stroke DCI is one tool that hospitals can leverage  to improve patient’s knowledge. 

Pre-intervention review of the stroke database from 6/01/19 through 09/30/19, provided a baseline for physician compliance with stroke specific DCI. An intervention bundle consisting of simple educational activities and reminders/decision support tools embedded in the EMR was executed in October of 2019. A review from 11/01/19 through 03/08/20, determined post-intervention success using the intervention.

The intervention bundle increased compliance with the use of stroke specific DCI by 38.6 %. Before the intervention the overall compliance was 51.9 %, compliance had increased to 90.5 % within 4 months. Improvements in compliance were seen in the teaching and non-teaching service, from 60% to 90.5 % and from 25% to 87.5% respectively.

This quality improvement project demonstrates that simple educational and decision support interventions can improve compliance with the use of stroke specific DCI, which in turn can help improve outcomes post-discharge by improving patient education.