Michigan Stroke Registry and Quality Improvement Program


Stroke is a form of cardiovascular disease that occurs when a blood vessel bringing oxygen to the brain bursts (hemorrhagic) or is clogged (ischemic). A trasient ischemic attack, often called a TIA or mini-stroke, is a type of ischemic stroke that resolves prior to treatment.

To improve the quality of care received while in the hospital during the acute phase of stroke, that Michigan Department of Health and Human Services in partnership with the American Heart and Stroke Associations, The Centers for Disease Control and Prevention (CDC) and other partners, is launching a Paul Coverdell National Acute Stroke Registry entitled the Michigan Stroke Registry and Quality Improvement Program. The program's mission is: To ensure that all Michiganders receive the highest quality of acute stroke care currently available and to reduce the number of premature deaths attributable to stroke, prevent stroke-related disability, and prevent stroke patients from suffering recurrent strokes.

Epidemiology Summary 

Stroke is the fourth leading cause of death in Michigan and the U.S., resulting in an enormous burden of mortality, morbidity, disability and health care costs. Stroke is a leading cause of serious, long-term disability in the U.S. as only 50-70% of stroke survivors regain functional independence and 20% are institutionalized within 3 months. Nearly a quarter of people who have their first stroke die within one year. Public health efforts are needed to reduce the risk of stroke among the general population, to increase recognition of stroke and ensure that people with stroke can access quality care, as well as improve rehabilitation and long term care of disability resulting from some strokes.

Stroke Epidemiology Staff

Stroke Registry Manager: Adrienne Nickles, MPH

What We Do 

The Michigan Stroke Registry and Quality Improvement Program utilized a stroke registry to implement a data driven approach to quality improvement. This process promotes change within individual hospitals and informs system and policy change across the state. A full-time Registry Manager, full-time Quality Improvement Specialist, and a part-time Audit Nurse staff the program. The staff focuses their efforts on the following activities aimed at meeting the CDC grant objectives:

  • Develop and maintain a stroke care registry to assess and track performance on 10 stroke care consensus measures.
  • Implement quality improvement methodologies that include working at the individual hospital level through specialized technical assistance and site visits as well as developing a newtork of participating hospitals to share best practices and lessons learned through monthly teleconferences, webinar trainings, and face-to-face learning sessions.
  • Integration of activities and findings with the Michigan Department of Health and Human Services (MDHHS) Heart Disease and Stroke Prevention program to improve care and target resources to benefit Coverdell activities as well as other heart disease and stroke prevention and control activities.
  • Raise awareness of and advocacy for system changes to improve stroke care through the Michigan Stroke Initiative (MSI), a multidisciplinary advisory group representing a variety of institutions involved in stroke care throughout the state. MSI will provide advice on direction, tools, and strategies for quality improvement as well as identify priorities and strategies for implementing stroke policies at the state level.



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