| Title: |
Association of a Rapid TIA Inpatient Care Pathway with Quality Metrics at an Urban Academic Medical Center |
| Authors: |
Saline, Austin; Pandya, Varun; Balogun, Oluwafemi; Islam, Tanzina; Upadrasta, Gautham; Okada, Chihiro; Aziz, Ali; Jadow, Benjamin; Gordon, Alexandra; Nagamalla, Vineela; Sartori, Alice; Rampersad, Ida; Duncan, Shelly Ann; Daza Ovalle, Juan Felipe; Ovbiagele, Bruce; Labovitz, Daniel; Esenwa, Charles |
| Source: |
The Neurohospitalist ; volume 16, issue 1, page 36-42 ; ISSN 1941-8744 1941-8752 |
| Publisher Information: |
SAGE Publications |
| Publication Year: |
2025 |
| Description: |
Background Transient ischemic attack (TIA) carries a high risk of stroke, necessitating immediate evaluation and risk modification. Patients in high-social determinants of health-burden communities often face barriers to rapid outpatient care, while inpatient admission can be resource-intensive and burdensome. We describe outcomes from a rapid TIA inpatient workflow (Rapid TIA) implemented at an urban academic medical center. Methods A retrospective single institution observational study of 411 consecutive patients admitted for TIA over 4 years in the Bronx, NY. Rapid TIA had 3 phases: (1) initial neurologic evaluation, (2) hospital admission and expedited implementation of care, and (3) transition to outpatient specialty care. We compared 6 variables related to care delivery, as well as long-term outcomes, in the pre-implementation vs post-implementation groups. Results The Rapid TIA program was associated with a significant improvement in overall care delivery measured using a composite process measure score from 3.2 (±1.1) pre-implementation to 3.8 (±1.1) post-implementation (OR 1.63, 95% CI: 1.35, 1.98, P = 0.001). Combined 1 year readmission rates for stroke/TIA, MI, and major bleeding events decreased from 15% (n = 28) in the pre-implementation group to 7% (n = 15) post-implementation (95% CI: 0.19, 0.74, P = 0.004). Conclusions Our study demonstrates that a rapid-inpatient TIA management pathway can significantly improve quality care and reduce readmissions. Rapid TIA may serve as a model for TIA care delivery in other underserved communities. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1177/19418744251374363 |
| Availability: |
https://doi.org/10.1177/19418744251374363; https://journals.sagepub.com/doi/pdf/10.1177/19418744251374363; https://journals.sagepub.com/doi/full-xml/10.1177/19418744251374363 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ ; https://journals.sagepub.com/page/policies/text-and-data-mining-license |
| Accession Number: |
edsbas.1DD78B31 |
| Database: |
BASE |