A new research has revealed that hospitals routinely overestimate their door-to-needle performance as well as their ability to deliver tissue plasminogen activation (tPA) to stroke patients on time.

Researchers of the study also reported that the biggest discrepancy between perceived and actual performance occurs at poorer performing facilities.

For the new study published in the Journal of the American Heart Association on July 22, Cheryl Lin, from Duke Clinical Research Institute, and colleagues surveyed the staff of over 140 U.S. hospitals that treated nearly 50,000 stroke patients from 2009 to 2010.

The researchers found that less than a third of the hospital staff was able to accurately identify their performance on stroke care and many of the hospitals overestimate their ability to timely deliver the clot-busting medication.

Eighty-five percent of low performing hospitals involved in the study were found to overestimate how quick they can administer the medication within the so called critical hour after the patient arrived at the hospital, which is higher compared with 42 percent in middle performing facilities.

The researchers likewise found that among the lowest performing hospitals, the staff generally believed that at least 20 percent of the patients they treated were administered treatment within an hour when none actually did.

Nearly 800,000 people in the U.S have a stroke per year and 87 percent of these are ischemic, which occurs when the blood flow to the brain is blocked often as a result of blood clots.

The tPA, which works by breaking down blood clots and thus improves the flow of the blood to the brain, is currently the only medication green-lighted by the U.S. Food and Drug Administration (FDA) for treating ischemic stroke.

It is recommended that tPA be administered to ischemic stroke patients within an hour of hospital arrival with research showing that patients get lower odds of getting short and long term complications with quicker administration of the drug.

Based on the result of the study, Lin said that protocol changes that would better align staff perception with their performance would have significant effect on the quality of care provided to stroke patients across the U.S.

"Hospitals often overestimate their ability to deliver timely tPA to treated patients. Our findings indicate the need to routinely provide comparative provider performance rates as a key step to improving the quality of acute stroke care," the researchers wrote in their study.

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