Abstract WP099: From Foundation to the Future: The Minnesota Experience in Statewide Stroke System Design, Implementation, and Continuous Improvement

Background: Since 2005, the Minnesota Department of Health (MDH) has worked with many partners to aggressively address the burden of stroke. In 2013, only 66% of Minnesota’s (MN)’s population lived within 30 minutes of a designated stroke hospital, which means a large percentage of the population could not access timely stroke care, limiting lifesaving or disability-preventing intervention.To address this, MDH developed a data collection platform, the MN Stroke Registry (MSR), and standards for stroke hospital designation which was enacted through legislation in 2013. Methods: MDH is quality improvement (QI) driven and supports a comprehensive approach that spans the entire care continuum- from the prehospital setting through the post-acute care environment. Through voluntary designation, we verify that care is routinely provided in accordance with current evidence-based guidelines, and we offer individualized recommendations for QI. We provide the MSR which enables hospitals to implement targeted QI initiatives. We also provide clinical resources, technical assistance (TA), training, and facilitate learning collaboratives to advance statewide QI initiatives. Results: Through the creation of a network of stroke designated hospitals, acute stroke treatment is available and accessible within a 30-minute drive for 94% of Minnesotans. To date there are 121 designated stroke hospitals including 97 Acute Stroke Ready Hospitals. All designated stroke hospitals have sustained their designation status. There are forty-six hospitals that primarily use the MSR and have continuously enhanced and improved their programs over time through various QI initiatives. Treatment times have improved since system implementation. Per MSR data, in 2015, 76% of acute ischemic stroke patients arriving within 3.5 hours of last known well received IV thrombolysis within 60 minutes. In 2023, 83% of patients received IV thrombolysis within 60 minutes. Conclusion: A coordinated, comprehensive stroke system of care—supported by robust data collection and stroke designation—ensure the effective management of stroke in MN. We recognize that gaps remain in access to designated stroke hospitals and will provide targeted TA to build local capacity. In conclusion, MDH remains committed to reducing burden of stroke by supporting hospitals through designation, advancing data collection and utilization, improving stroke prevention and quality of stroke care, and addressing health disparities.