Department of Neurology Celebrates Florida Stroke Registry’s 10th Anniversary
Led by a dedicated team of University of Miami Miller School of Medicine neurologists and researchers, the Florida Stroke Registry (FSR) celebrated a decade of contributions to the state’s health improvement plan at its 10th anniversary stakeholder meeting in Orlando.
“Since its launch a decade ago, this collaborative initiative has raised the bar in quality stroke care in our state, making Florida a model for the nation to follow,” said Ralph L. Sacco, M.D., M.S., FSR executive director, professor and Olemberg Chair of Neurology at the Miller School, and executive director of the Evelyn McKnight Brain Institute. “The registry’s mission is advancing the quality of stroke care by transforming data into actions that save lives and reduce disability after stroke.”
More than 100 stakeholders including health professionals and patient/ caregivers from around the state attended the FSR’s August anniversary meeting, which featured keynote speaker Joseph A. Ladapo, M.D., Ph.D., the state surgeon general. “The anniversary meeting not only celebrated 10 years of success, but also introduced and welcomed new FSR stakeholders such as EMS and community health workers,” said Carolina M. Gutierrez, Ph.D., FSR program director and scientist in the Department of Neurology.
“At the meeting, we reviewed the dramatic improvements in stroke care in the last decade and engaged stakeholders from across the state to continue the process of improving care for stroke, which affects minorities disproportionately,” said Jose G. Romano, M.D., FSR director of education and training, professor of neurology, and chief of the Stroke Neurology Division.
Drs. Sacco, Gutierrez, and Romano added that the FSR has been successful at identifying and correcting inequities in the delivery of acute stroke care, through a process that includes measuring and providing feedback, as well as disseminating best practices and education.
“The longer you do evidence-based care, the more disparities are reduced,” said Dr. Sacco. “For example, when looking at the overall quality of stroke care measure ‘Defect-Free Care,’ we have shown improvements across time with reduction in disparities by race/ethnic group.”
A Decade of Accomplishments
The Florida Stroke Registry began in 2012, under Dr. Sacco’s direction, as a National Institutes of Health-funded program charged with reducing health disparities in acute stroke treatment and improving stroke care in Florida and Puerto Rico.
Since its founding, the FSR has continuously collected data, analyzed the findings, and provided reports that outline best practices in stroke care, said Dr. Romano. For example, FSR data helped increase the use of clot-busting drug tissue plasminogen activator, or tPA, in eligible stroke patients. In Florida, tPA treatment within 60 minutes of hospital arrival rose from 19% in 2010 to 92% in 2020, and treatment within 45 minutes of arrival went from 6 to 75% over the same time span.
The FSR was also one of the first U.S. initiatives to provide data-driven perspectives of race, ethnic, sex and geographic stroke disparities.
“Data from 2010 to 2017 revealed that Black stroke patients were less likely to receive tPA compared to white patients, and the state’s stroke centers worked to eliminate that disparity,” said Dr. Romano.
State Support for Stroke Care
When the five-year NIH funding was over, the state legislature in 2017 enacted a statute supporting and funding the FSR to ensure the quality of stroke care for all Floridians through the State Health Improvement Plan. Two years later, data from the FSR was instrumental in changing the requirements for the state’s stroke centers.
“Now, a hospital stroke center must be nationally certified, rather than self-attesting,” said Dr. Gutierrez. “Hospitals are able to improve or see gaps their quality of stroke care through ongoing tracking and measuring of hospital data provided through the FSR Dashboards, and the FSR is committed to providing this type of resource to participating hospitals.”
Currently, 167 of the state’s approximately 175 stroke centers are participating fully in the FSR, which recently received three years of funding from the U.S. Centers for Disease Control and Prevention in the Paul Coverdell National Acute Stroke Program.
“As a Coverdell stroke registry, the FSR’s goal is to drive an efficient Florida stroke system of care,” added Dr. Gutierrez. “This Florida Coverdell Project will expand the FSR’s data infrastructure to include greater pre-hospital emergency medical services and post-discharge outcomes data.”