Cardiovascular Health Indicator
Measure: Door-to-Needle within 60 minutes

Analysis

The number of emergency ischemic stroke patients who had IV thrombolytics initiated within 60 minutes of arrival at the emergency department has increased significantly since 2013. Table 1 and Chart 1 show the number of ischemic stroke patients who received IV thrombolytics, along with the number and percentage of patients who had these drugs initiated within 60 minutes of arrival in the emergency department.

Table 1: Total Number and Percentage of Emergency Ischemic Stroke Patients who had IV-thrombolytics initiated within 60 minutes of arrival at Minnesota hospitals, 2013-2020

Chart 1 shows the number of ischemic stroke patients receiving clot busting drugs increasing from 2013 through 2018. There was a small decline in 2019, followed by a large decline in 2020. The blue part of the bar shows the number of patients for whom IV-thrombolytics were initiated within 60 minutes. While the number of patients receiving clot busting drugs overall has increased significantly, the percentage of patients of patients where IV-thrombolytics are initiated within 60 minutes has increased only slightly from 2013 to 2020. Overall, there has been sustained high performance on this measure over the last eight years.

Chart 1: Total Number and Percentage of Emergency Ischemic Stroke Patients who had IV-thrombolytics initiated within 60 minutes of arrival at Minnesota hospitals, 2013-2020

Table 2 and Chart 2 highlight differences in initiating IV-thrombolytics within 60 minutes by type of hospital, with non-designated hospitals performing significantly worse than hospitals who have received designation for their stroke care. Primary or Comprehensive Stoke Centers have shown sustained high performance on this treatment goal since 2013, reaching their highest performance in 2020. Hospitals designated as Acute Stroke Ready Hospitals by the Minnesota Department of Health had a decline in this treatment goal from 2013 to 2014, followed by steady performance through 2020. The performance gap between these two types of facilities has remained relatively steady since 2015.

Hospitals who have not received any designation for their stroke care have shown inconsistent performance in their ability to initiate IV-thrombolytics within 60 minutes of arrival, lower than designated hospitals in all years. Since 2017, there have been fewer than 5 instances of IV-thrombolytics given at non-designated hospitals each year and are no longer compared against the majority of hospitals in Minnesota.

Table 2: Percentage of Emergency Ischemic Stroke Patients who had IV-thrombolytics initiated within 60 minutes of arrival by Minnesota Stroke Program Designation Level, 2013-2020

n/a: Acute Stroke Ready Hospitals were first designated in Minnesota in April 2014

n/r: Fewer than 5 administrations of IV-thrombolytics annually

Chart 2: Percentage of Emergency Ischemic Stroke Patients who had IV-thrombolytics initiated within 60 minutes of arrival by Minnesota Stroke Program Designation Level, 2013-2020

Other Resources

Minnesota Stroke System

The Minnesota Stroke System promotes a coordinated system of care to ensure all hospitals are equipped and ready to provide the best care possible for all Minnesotans. This system was launched in April 2014 with the designation of the first Acute Stroke Ready hospitals in Minnesota.

Data Source

The data were obtained from the Minnesota Statewide Quality Reporting and Measurement System (SQRMS), collected from hospitals by the Minnesota Stroke Program at the Minnesota Department of Health. The dataset captures the triage and treatment of stroke patients in Minnesota hospital Emergency Departments.

Measure Definition

Find more detail about Stroke Quality Measures and other Health Care Quality Measures in the Statewide Quality Reporting & Measurement System at the Minnesota Department of Health.