Limited access is a major hurdle in the treatment of AIS; many hospitals, especially rural
hospitals, do not have the infrastructure or medical support to effectively treat AIS
patients.5 Failure to recognize the signs and symptoms of stroke by the patient and/or
emergency medical services (EMS) is another barrier to the timely treatment of AIS. Several
studies, including the Paul Coverdell National Acute Stroke Registry (PCNASR), have reported
low rates of adherence to stroke care guidelines, suggesting that many AIS patients do not
receive proper treatment according to established guidelines. Thus, there remains an
increasing need to assess and address the barriers that prevent patient access to proper AIS
treatment.
Annually, approximately 20,000 patients are discharged from Wisconsin hospitals with the
diagnosis of stroke and an estimated 4,000 patients die from stroke each year in WI. To date,
there have been no statewide studies initiated in Wisconsin to assess the regional barriers
to the treatment of AIS patients with thrombolytic or endovascular therapy, and many
hospitals do not routinely collect and analyze AIS patient data.
The goal of the Improving Patient Access to Stroke Therapy (IMPACT) pilot study is to engage
community hospitals statewide to identify the regional barriers to AIS therapy in WI.