Combined Assessment Program Summary Report – Evaluation of Acute Ischemic Stroke Care in Veterans Health Administration Facilities

The purpose of the review was to determine the extent to which Veterans Health Administration facilities complied with selected requirements for the assessment and treatment of patients who had acute ischemic stroke symptoms. We conducted this review at 50 Veterans Health Administration medical facilities during Combined Assessment Program reviews performed across the country from April 1, 2014, through March 31, 2015. Although we observed many positive practices, we identified several opportunities for improvement. Discussion with managers at several levels of the Veterans Health Administration indicated that considerable activity is underway to reassess the requirements for stroke care and make improvements across the system. We recommended that the Under Secretary for Health improve the availability of expertise in stroke treatment across the system. We also recommended that the Under Secretary for Health, in conjunction with Veterans Integrated Service Network and facility senior managers, ensure compliance with stroke care requirements, including prompt and thorough assessment, treatment, and patient education, and ensure the gathering and reporting of required stroke data elements.