tPa Stroke Treatment, Surgical Service Line Enhancements and ERAS Care Standardization Case Studies

Greater Baltimore Medical Center (GBMC) was named a 2019 HIMSS Davies Enterprise Award recipient for leveraging the value of health information and technology to improve outcomes. The three case studies below cover how the organization improved tPa stroke treatment rates and quality of life for ischemic stroke patients, enhanced surgical service lines, and implemented order sets to standardize care through an Enhanced Recovery After Surgery (ERAS) program.

Case Studies

1. Improving tPA Rates to Enhance Quality of Life for Stroke Patients

GBMC realized that their tPA stroke treatment rates were lower than state and national benchmark rates. To address this, they set a goal to leverage their EHR to improve recognition of qualified patients for tPA stroke treatment and to administer tPA more efficiently and safely. Their efforts exceeded national and state benchmarks while remaining in line with the American Heart Association’s "Get with the Guidelines" standards.

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2. Leveraging Data and Technology to Improve Surgical Site Infection Rates

By collaborating with their EHR vendor, GBMC developed an automated, bidirectional workflow with the American College of Surgeon’s National Surgical Quality Improvement Program (ACS-NSQIP). With the comparison of benchmark data from ACS-NSQIP, the organization developed a performance improvement strategy and governance structure to identify areas of improvement in their surgical service lines. As their EHR evolved, internal real-time data evaluation—displayed in surgical dashboards—was made available to all surgeons in the organization, which improved transparency, accountability and adherence to protocols.

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3. Using Order Sets to Standardize Care in an ERAS Program

The true benefits of an ERAS program were made evident when GBMC implemented an ERAS program for colorectal surgery. With custom-built order sets using the latest evidence-based medicine, GBMC integrated standard order sets and protocols for colorectal patients across the care continuum—pre-operative interventions, intra-operative care, post-operative recovery and into discharge—and realized significant benefits.

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Updated March 6, 2020