Cardiovascular Health Indicator
Measure: Door-to-Imaging within 25 minutes

Analysis

The number of emergency stroke patients who had brain imaging scan initiated within 25 minutes of arrival at the emergency department has increased significantly since 2013. Table 1 and Chart 1 show the number of patients who are suspected of having a stroke and that stroke symptoms began with the last 3.5 hours, along with the number and percentage of these patients who had a brain imaging scan initiated within 25 minutes of arrival in the emergency department. This measure is significantly higher (up by 13 percentage points) since 2013, but has stayed relatively stable over the most recent two years.

Table 1: Total Number and Percentage of Emergency Stroke Patients who had a Brain Imaging Scan initiated within 25 minutes of arrival at Minnesota hospitals, 2013-2020

Chart 1 shows the number of brain imaging scans performed on emergency stroke patients increasing from 2013 through 2019. This is due to a number of factors, but is largely due to an increase in the number of hospitals reporting these data and better documentation of when a patient was last known to be without stroke symptoms. The drop in brain imaging scans performed in 2020 is consistent with hospitalization data showing fewer stroke cases coming to hospitals in the first year of the COVID-19 pandemic. The blue part of the bar shows the number of patients for whom brain imaging was initiated within 25 minutes. Both the number and percentage of patients with a brain imaging scan initiated within 25 minutes has increased significantly from 2013 to 2020.

Chart 1: Total Number and Percentage of Emergency Stroke Patients who had a Brain Imaging Scan initiated within 25 minutes of arrival at Minnesota hospitals, 2013-2020

Improvements in rapid brain imaging for emergency stroke patients have occurred at all types of hospitals in Minnesota. However, hospitals designated as Primary or Comprehensive Stoke Centers or Acute Stroke Ready Hospitals by the Minnesota Department of Health are much more likely to initiate brain imaging scans on emergency stroke patients within 25 minutes than hospitals who have not received designation for their stroke care. Table 2 and Chart 2 highlight differences in rapid brain imaging within 25 minutes by type of hospital, with non-designated hospitals performing significantly worse than hospitals who have received designation for their stroke care. As shown in Chart 2, hospitals designated by the State of Minnesota for their stroke care have shown sustained improvement in rapid brain imaging over this time period. In most years, they have performed at a higher level than hospitals designated as Primary or Comprehensive Stroke Centers. The gap between designated hospitals and non-designated hospitals has been wide from 2013 through 2020.

Table 2: Percentage of Emergency Stroke Patients who had a Brain Imaging Scan initiated within 25 minutes of arrival by Minnesota Stroke Program Designation Level, 2013-2020

*Acute Stroke Ready Hospitals were first designated in Minnesota in April 2014

Chart 2: Percentage of Emergency Stroke Patients who had a Brain Imaging Scan initiated within 25 minutes of arrival by Minnesota Stroke Program Designation Level, 2013-2020

Other Resources

Minnesota Stroke System

The Minnesota Stroke System promotes a coordinated system of care to ensure all hospitals are equipped and ready to provide the best care possible for all Minnesotans. This system was launched in April 2014 with the designation of the first Acute Stroke Ready hospitals in Minnesota.

Data Source

The data were obtained from the Minnesota Statewide Quality Reporting and Measurement System (SQRMS), collected from hospitals by the Minnesota Stroke Program at the Minnesota Department of Health. The dataset captures the triage and treatment of stroke patients in Minnesota hospital Emergency Departments.

Measure Definition

Find more detail about Stroke Quality Measures and other Health Care Quality Measures in the Statewide Quality Reporting & Measurement System at the Minnesota Department of Health.