Dataset Information

Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatment in Taiwan.

ABSTRACT:

Background and purpose

Recombinant tissue plasminogen activator (rtPA) is one of the proven therapies that improve the outcome of patients with acute ischemic stroke (AIS). In 2009, the Ministry of Health and Welfare, Executive Yuan, Republic of China, launched the project "Hospital Emergent Capability Accreditation by Level-Stroke (HECAL-Stroke)" to improve AIS treatment in Taiwan. The current study was performed to determine whether the project launched by the government was effective in promoting rtPA therapy among AIS patients.

Methods

All participating hospitals were verified and designated as "heavy duty (HD)," "moderate duty (MoD)," or "medium duty (MeD)" according to the stroke center criteria. Four annual indices (rates of treatment, protocol adherence, in-time treatment, and complications) were recorded from 2009 to 2014 as outcome measures. The data were analyzed using the ?² test for significance.

Results

The number of certified hospitals progressively increased from 74 to 112 during the 6-year period and finally consisted of 33 HD, 9 MoD and 70 MeD hospitals in 2014. The annual intravenous rtPA treatment rate increased significantly from 3.0% in 2009 to 4.5% in 2014. The protocol adherence rates were 95.7% in the HD group, 92.4% in the MoD group and 72.8% in the MeD group. The annual in-time treatment rate significantly improved from 26.0% in 2009 to 60.1% in 2014. The overall symptomatic intracranial hemorrhagic rate after rtPA treatment was 8.6%.

Conclusions

Initiation of the HECAL-Stroke project by the government significantly improved rtPA treatment in Taiwan.

SUBMITTER: Cheng TJ

PROVIDER: S-EPMC5466286 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Publications

Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatment in Taiwan.

Cheng Tain-Junn TJ Peng Giia-Sheun GS Jhao Wei-Siang WS Lee Jiunn-Tay JT Wang Tsung-Hsi TH

Journal of stroke 20170531 2

<h4>Background and purpose</h4>Recombinant tissue plasminogen activator (rtPA) is one of the proven therapies that improve the outcome of patients with acute ischemic stroke (AIS). In 2009, the Ministry of Health and Welfare, Executive Yuan, Republic of China, launched the project "Hospital Emergent Capability Accreditation by Level-Stroke (HECAL-Stroke)" to improve AIS treatment in Taiwan. The current study was performed to determine whether the project launched by the government was effective ...[more]

PMID: 28592784

Similar Datasets

Project description:BACKGROUND: Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan. METHODS: The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C). Hospitals and their healthcare workers participated in the survey on a voluntary basis. The psychometric properties of the five SAQ-C dimensions were examined, including teamwork climate, safety climate, job satisfaction, perception of management, and working conditions. Additional safety measures were asked to assess healthcare workers' attitudes toward their collaboration with nurses, physicians, and pharmacists, respectively, and perceptions of hospitals' encouragement of safety reporting, safety training, and delivery delays due to communication breakdowns in clinical areas. The associations between the respondents' attitudes to each SAQ-C dimension and safety measures were analyzed by generalized estimating equations, adjusting for the clustering effects at hospital levels. RESULTS: A total of 45,242 valid questionnaires were returned from 200 hospitals with a mean response rate of 69.4%. The Cronbach's alpha was 0.792 for teamwork climate, 0.816 for safety climate, 0.912 for job satisfaction, 0.874 for perception of management, and 0.785 for working conditions. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct. The percentage of hospital healthcare workers holding positive attitude was 48.9% for teamwork climate, 45.2% for perception of management, 42.1% for job satisfaction, 37.2% for safety climate, and 31.8% for working conditions. There were wide variations in the range of SAQ-C scores in each dimension among hospitals. Compared to those without positive attitudes, healthcare workers with positive attitudes to each SAQ dimension were more likely to perceive good collaboration with coworkers, and their hospitals were more likely to encourage safety reporting and to prioritize safety training programs (Wald chi-square test, p < 0.001 for all). CONCLUSIONS: Analytical results verified the psychometric properties of the SAQ-C at Taiwanese hospitals. The safety culture at most hospitals has not fully developed and there is considerable room for improvement.

Dataset Information

Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatment in Taiwan.

Background and purpose

Methods

Results

Conclusions

Publications

Nationwide "Hospital Emergent Capability Accreditation by Level-Stroke" Improves Stroke Treatment in Taiwan.

Similar Datasets

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