Making Strides in Rural Stroke Care Using Get With The Guidelines  

Sandy Duha, BSN, RN, Supervisor, Acute Hospital, Gundersen Boscobel Area Hospitals and Clinics, Wisconsin 

"We have seen great strides in our stroke program since we began participating in Get With The Guidelines (GWTG). Previously, we didn't have a stroke coordinator and we weren't really tracking metrics. The GWTG rural stroke measures have allowed us to track our metrics and determine where there is opportunity for improvement. We have implemented quality improvement processes and have seen great improvement in dysphagia screening, documentation of time last known well (TLKW) and documentation of the National Institutes of Health Stroke Scale (NIHSS).  

We have administered thrombolytics three times this year — all in under 60 minutes, with our most recent one being under 30 minutes! We are excited to see what other opportunities we will have to continue to move our program forward and help our patients achieve the best possible outcomes." 

Using the Rural Health Care Outcomes Accelerator to Overcome Health Care Challenges 

Taylor Labert, RN, Assistant Director of Nursing Services, Columbia County Health System, Washington

"As a small, rural facility, our biggest challenges are lack of resources and difficulty transferring patients out that need a higher level of care than we can provide — for example, surgery or specialty services such as urology or pediatrics. In addition, many employees want to fill in gaps and unit needs and may often find themselves struggling to prioritize the most essential needs. This means staff often need to cross-train and be confident in several areas, which might not be the case at a larger, urban hospital.

The Rural Health Care Outcomes Accelerator was a great opportunity to incorporate quantitative goals and increase our knowledge base to improve patient care, as well as collaborate with other facilities nearby to ensure consistent care and communication. This is a great way to gauge our progress and celebrate the measures that our staff are meeting. It also helps ensure we are following evidence-based practices and meeting criteria for optimum patient care. Get With The Guidelines helps us track the most pertinent statistics, to see where we are exceeding expectations and areas we can work on for improvement.

This program is a great resource and support for rural providers. The American Heart Association helps us to remain up to date with evidence-based practices, celebrate our wins and provide guidance on ways we can improve care.

Participating in the Rural Health Care Outcomes Accelerator has helped us make positive changes, such as improving workflows, editing our electronic health record system notifications and making medication changes. For example, we have made changes in our fibrinolytic medication choices to follow similar guidelines to other facilities in our area to have a standard approach. We have disseminated this education to staff throughout our facility, as well as the time goals associated with administering fibrinolytics versus transferring to a higher level of care."

Using Get With The Guidelines to Become Stroke Certified in Rural Florida

Dakota Redd, CNO, Hendry Regional Medical Center, Florida

"Hendry Regional Medical Center achieved disease specific certification for stroke through The Joint Commission in October 2023. This accomplishment was the result of hard work and commitment from the team of medical professionals and support staff at Hendry Regional and led by our stroke steering committee and Stroke Coordinator, Tracy Victory.

Using the Get With The Guidelines® framework as part of the Rural Health Care Outcomes Accelerator, Tracy leads her multi-disciplinary team in monitoring and evaluating the stroke care delivered in our rural Critical Access Hospital in South Florida. The metrics collected and reported during the past 2 years clearly show the value of using the guidelines in focusing activities to provide, measure and monitor the delivery of high-quality care.

Through the support of senior leadership, Hendry Regional aligns with the mission to excel in quality, compassion, and innovation to make our community healthier. This is demonstrated with our commitment to pursue these advanced certifications for both Stroke Certification, and Heart Attack Ready Certification through The Joint Commission, utilizing the best practice models tested and proven from the American Heart Association, Get With The Guidelines, and the innovation and inclusion that our teams bring every day."