At Cedars-Sinai, the care given to persons who have had a stroke is measured against the standards created in the Get With the Guidelines program sponsored by the American Heart Association and the American Stroke Association.
The Get with the Guidelines - Stroke program is an in-hospital program designed to improve the treatment given to people who have had an acute stroke. The guidelines are based on the latest scientific research in the treatment of stroke. They focus on quick diagnosis and treatment after a stroke and actions to prevent future strokes.
Currently, more than 1,257 hospitals are participating in the Get With the Guidelines program. They have contributed information on 589,559 patients.
The American Heart Association and the American Stroke Association have recognized Cedars-Sinai Medical Center with a Gold (Sustained) Performance Achievement Award in 2008. This award recognizes Cedars-Sinai's performance over 24 consecutive months. This prestigious award demonstrates compliance in the seven core Get With The Guidelines Stroke measures with at least 85% of all eligible patients.
Cedars-Sinai received the Gold Award in 2007 and the Silver (Annual) Performance Achievement Award in 2006. This award recognizes that the Medical Center has followed treatment guidelines in certain key measures at least 85% of the time for one year.
Cedars-Sinai was awarded the Bronze Achievement Award in 2005 from the American Heart Association and the American Stroke Association. This award recognizes 90 consecutive days of more than 85% compliance in each of the seven core stroke measures.
Cedars-Sinai was awarded the Initial Achievement Award from the American Heart and American Stroke associations in 2005 for its entry of baseline data into the Get With the Guidelines national database.
The data below on stroke patients treated at Cedars-Sinai reflects treatment given to 576 stroke patients discharged during 2006.
The chart below compares the type of patients treated at Cedars-Sinai Medical Center with all patients reported by hospitals nationally participating in the Get With the Guidelines program.
| Stroke Patient Demographics | Cedars-Sinai | "Get With the Guidelines" Participating Hospitals |
| Average Age | 73 | 72 |
| Men | 46.7% | 46.5% |
| Women | 53.3% | 53.5% |
Patients treated at Cedars-Sinai Medical Center had one of the following types of strokes:
- Hemorraghic, where blood leaks from a blood vessel into brain tissue. This type of stroke can take two forms. A Subarachnoid hemorrhage where a blood vessel just outside thye brain ruptures. The area of the skull surrounding the brain (the subarachnoid space) quickly fills with blood. The second type is an intracerebral hemorrhage, in which there is bleeding inside the brain that causes a build up of pressure and damage to brain cells.
- Ischemic, where a blood clot shuts off the flow of blood to parts of the brain
- Transient ischemic attacks (TIA)
The chart below compares the percentage of people treated for each type of stroke at Cedars-Sinai and nationally.
| Types of Strokes Treated 2007 | Cedars-Sinai | Get With the Guidelines Participating Hospitals |
| Hemorrhagic | 22% | 14% |
| Ischemic | 57% | 58% |
| Transient Ischemic Attack (TIA) | 21% | 24% | Not specified | 0% | 3% |
Tissue plasminogen activator (tPA) is a clot-busting drugs. Most strokes are caused by blood clots that stop or disrupt the flow of blood to the brain. The drug tPA has been shown to be effective in treating ischemic stroke. Since 1996, tPA has been approved by the U.S. Food and Drug Administration to treat ischemic stroke in the first three hours after the symptoms start. Given promptly, tPA can significantly reduce the effects of stroke. This in turn, helps reduce permanent disability following a stroke.
The chart below shows how often tPA was considered in the treatment of stroke patients at Cedars-Sinai. These data are compared to hospitals nationally.
| tPA Considered | Cedars-Sinai | Get With the Guidelines Participating Hospitals |
| January - March 2006 | 100% | 74.1% |
| April - June 2006 | 100% | 75.3% |
| July - August 2006 | 100% | 79.3% |
| September - December 2006 | 100% | 80.8% |
The chart below shows how often tPA was given to treat stroke patients (who met the criteria for receiving tPA) at Cedars-Sinai. These data are compared to hospitals nationally.
| tPA Administered | Cedars-Sinai | Get With the Guidelines Participating Hospitals |
| January - March 2007 | 100% | 93.0% |
| April - June 2007 | 100% | 93.9% |
| July - August 2007 | 100% | 93.0% |
| September - December 2007 | 100% | 94.6% |
Patient education following a stroke can help prevent future strokes. The chart below compares how many Cedars-Sinai patients received education following a stroke compared to hospitals nationally.
| Stroke Education for Patients | Cedars-Sinai | Get With the Guidelines Participating Hospitals |
| January - March 2007 | 100% | 72.2% |
| April - June 2007 | 100% | 75.3% |
| July - August 2007 | 96.4% | 79.7% |
| September - December 2007 | 100% | 81.5% |
A stroke can cause damage to the brain that makes it difficult for a person to return to his or her normal daily activities. Rehabilitation after a stroke can help a person live with any remaining effects of a stroke. It can also help the brain recover more fully. The chart below shows the percentage of stroke patients treated at Cedars-Sinai for whom a rehabilitation plan was considered. These data are compared to hospitals nationally.
| Stroke Rehab Plan Considered | Cedars-Sinai | Get With the Guidelines Participating Hospitals |
| January - March 2007 | 100% | 92.2% |
| April - June 2007 | 100% | 92.6% |
| July - August 2007 | 100% | 93.1% |
| September - December 2007 | 100% | 93.2% |
Of the patients admitted to Cedars-Sinai Medical Center following a stroke, 7% died while in the hospital. This compares to an average of 6% for other hospitals nationally participating in the Get With the Guidelines program.
It should be noted that the patients with strokes treated at Cedars-Sinai Medical Center were older than the average for medical centers tracked nationally. In addition, Cedars-Sinai treated more patients with more serious types of strokes than the national average.
The following chart shows the percentage of patients who were discharged to their own homes (with and without home health care), inpatient rehabilitation, skilled nursing facilities or other places. (Not included in these numbers are patients who were readmitted to the Medical Center or who died.)
| Destination After Discharge | Cedars-Sinai |
| Home | 50% |
| Inpatient rehabilitation | 23% |
| Skilled nursing facility | 10% |
| Expired | 9% |
| Another institution for inpatient care | 4% |
| Home with home health care | 2% |
| Intermediate care facility | 1% |
| Against Medical Advice (AMA) | 0.05% |
| Hospice | 0.5% |
A patient's ability to do activities of daily living without help is measured by a tool called the Functional Independence Measure (FIM). Using this tool, rehabilitation specialists working with patients can measure their progress from admission through discharge.
The FIM looks at 18 discrete functions of daily life to rate the patient's severity of disability and level of independence. Each functional item is rated on a seven-point scale. Scores can range from 18 (totally dependent) to 126 (totally independent). Areas rated include the patient's ability to care for him or herself, sphincter control, mobility, communication and social cognition. An interdisciplinary team at admission and again at discharge performs assessments to measure attainment of a patient's specific goals.
The chart below shows the average functional independence score of patients admitted to Cedars-Sinai following a stroke, the improvement in FIM score during treatment and their FIM score at discharge.
| Functional Independence Measure* | On Admission | At Discharge | Improvement from Admission to Discharge |
| January - March 2007 | 60.5 | 80.8 | 20.3 |
| April - June 2007 | 54.9 | 76.4 | 21.5 |
| July - August 2007 | 54.7 | 77.9 | 23.2 |
| September - December 2007 | 61.0 | 82.1 | 21.1 |
