Over the past ten years professional organizations, nonprofit stroke organizations, and federal health agencies have been working on the development of quality improvement interventions for stroke prevention and care. The following summary presents the chronology of national and New Jersey initiatives:
- 1996: FDA approved Tissue Plasminogen Activator (t-PA) a thrombolytic agent (clot-busting drug) used to treat ischemic strokes.
- 1997: National Stroke Association (NSA), a Program with national expertise and leadership, published Stroke Center Recommendations.
- 1999: The American Heart Association (AHA) and American Stroke Association (ASA), national voluntary health agencies, launched Operation Stroke.
- 2000: American Academy of Neurology created the Stroke Practice Improvement Network (SPIN).
- 2000: The Brain Attack Coalition (BAC) published Primary Stroke Center Recommendations. The BAC is a group of professional, voluntary and governmental entities dedicated to reducing the occurrence, disabilities and death associated with stroke.
- 2001: Congress appropriated 4.5 million to the Centers for Disease Control and Prevention (CDC) for the development of a national stoke registry and directed the registry to be named the Paul Coverdell Stroke Registry (after a U.S. Senator).
- 2001: CDC convened a national multidisciplinary panel of experts to review and revise the initial list of stroke measures and develop the registry data elements and design test registry protocol.
- 2001: AHA/ASA Get With The Guidelines (GWTG) Stroke Pilot was launched. A web-based program created to help hospitals improve the quality of care they provide to stroke patients.
- 2002: The Federal Legislation known as Stroke Treatment and Ongoing Prevention (STOP) Act was filed.
- 2003: Joint Commission on Accreditation of Healthcare Organizations (JCAHO) an independent, not-for-profit organization that evaluates and accredits programs and healthcare organization launched their Primary Stroke Certification.
- 2007: CDC’s Paul Coverdell National Stroke Registry, Joint Commission’s Primary Stroke Center Certification Program and AHA/ASA GWTG harmonized all three programs and reached a consensus for one set of performances measures.
New Jersey Initiatives
- 2004: New Jersey enacted the “Stroke Center Act” (P.L. 2004, c. 136, codified at N.J.S.A. 26:2H-12.27 through 26:2H12.32) which requires the Department of Health and Senior Services (Department) to designate licensed general hospitals that meet certain standards as either Primary or Comprehensive Stroke Centers.
- 2005: The Department issued a Request for Application (RFA) for the Stroke Center Designation Grant.
- 2006: The Department proposed new rules (N.J.A.C. 8:43G-7A) that applied to all designated Stroke Centers to maintain a database that supports evaluation of outcomes and continuous quality improvements.
- 2007: The Department began receiving licensing applications from hospitals for Stroke Center Designation.
- 2007: The Department launched a Stroke Data Registry project.
- 2008: The Department convened its first Stroke Advisory Panel meeting.
- 2010: The Department launched the New Jersey Acute Stroke Registry (NJASR).