Pramit Jagtap

A retrospective analysis was conducted for the "Standardized Inpatient Telestroke to Improve Guideline Adherence and Patient Metrics" study. This project investigated the efficacy of a standardized inpatient telestroke consultation model implemented across five rural "acute stroke ready" hospitals that lacked in-person neurologist coverage. The main research objective was to determine if transitioning from a telephone-triage model to a standardized telestroke workflow significantly improved adherence to American Heart Association (AHA) stroke guidelines. The tested hypothesis was that this intervention increased the rate of complete stroke evaluations, including comprehensive diagnostic workups and secondary prevention planning, and subsequently reduced adverse clinical outcomes. Specifically, the intervention's impact was quantified on metrics such as discharge on antithrombotic therapy, anticoagulation therapy for atrial fibrillation, thrombolytic therapy, and discharge on statin medications, as well as assessments of modified Rankin scores and the National Institutes of Health stroke scale. To achieve this, a quantitative approach based on a stepped-wedge implementation design was utilized to analyze patient data from the "Get With The Guidelines" stroke registry and the electronic health record. Clinical variables were abstracted and validated with a specific focus on medication and scoring documentation. Logistic regression analyses were performed using R software to calculate adjusted odds ratios for guideline adherence metrics while controlling for covariates such as age, sex, race, and stroke severity. Finally, variables were coded to measure the effect of the intervention to determine if it drove statistically significant improvements in the documentation and prescription of secondary prevention therapies and in-hospital procedural targets.