Stroke coordination by PAs and NPs

Following a clustered randomized trial on quality improvement efforts for stroke and a national acute ischemic stroke directive in the Veterans Health Administration in 2011, the role of PAs and NPs was assessed at 11 VA medical centers annually. Five of 11 facilities independently chose to staff stroke coordinator positions with PAs or NPs. Analysis indicated that PAs and NPs emerged as boundary spanners across services and disciplines and played an important role in coordinating evidence-based, facility-level approaches to acute ischemic stroke care. The presence of PAs and NPs was related to engaging in group-based evaluation of performance data, implementing stroke protocols, monitoring care through data audit, convening interprofessional meetings involving planning activities, and providing direct care. The presence of PAs and NPs appears to be influential in developing an advanced, facilitywide approach to stroke care.(1)