Target: Stroke, launched by the American Heart Association/American Stroke Association in 2010, is a national quality improvement initiative focused on improving acute ischemic stroke care by reducing door-to-needle times for eligible patients being treated with tPA.
The benefits of tPA in patients with acute ischemic stroke are time-dependent, and guidelines recommend a door-to-needle time of 60 minutes or less. However, studies have found that less than 30 percent of U.S. patients are treated within this window. Evidence also suggests disparities in timely treatment in patients who are older, African-American or female.
In its first year, Target: Stroke enrolled more than 1,200 U.S. hospitals. Participating hospitals committed to reaching the Target: Stroke performance goal of 50 percent or more of eligible patients treated with tPA within 60 minutes of hospital arrival. Ten key strategies were employed to meet this goal, including EMS prenotification of hospitals, activating the stroke arrival team with a single call, rapid acquisition and interpretation of brain imaging, use of specific protocols and tools, premixing tPA, a stroke-team-based approach and rapid performance data feedback.
All Get With The Guidelines-Stroke® hospitals are encouraged to participate in Target: Stroke. Each hospital will receive a detailed toolkit, including the 11 key strategies, protocols, stroke screening tools, order sets, algorithms, time trackers, patient education materials and other tools.
Target: Stroke Phase II aims to continue to reduce door-to-needle times for eligible patients being treated with tPA by establishing more aggressive goals for participating hospitals. The goals for Target: Stroke Phase II are:
- Primary Goal: Achieve door-to-needle times within 60 minutes in 75 percent or more of acute ischemic stroke patients treated with IV tPA.
- Secondary Goal: Achieve door-to-needle times within 45 minutes in 50 percent or more of acute ischemic stroke patients treated with IV tPA.