HealthDay News — Many U.S. hospitals don’t deliver tissue plasminogen activator (tPA) to stroke patients as fast as they think, according to a study published in the Journal of the American Heart Association.

Researchers surveyed staff in 141 hospitals across the United States who treated 48,201 stroke patients in 2009 and 2010, and compared their responses with patient data. Hospitals in the study participated in the American Heart Association’s “Get With the Guidelines: Stroke” program, which aims to improve stroke care. The results revealed significant differences between staff perception and reality. Only 29% of staff correctly estimated how long it took stroke patients at their hospital to receive tPA.

Hospitals were ranked as high-, middle-, or low-performing based on the percentage of cases where stroke patients received tPA within the recommended time. Eighty-five percent of low-performing hospitals and 42% of middle-performing hospitals overestimated their abilities to quickly administer tPA. Nearly one in five low-performing hospitals believed the time it took them to administer treatment was better than the national average. The researchers also found that hospitals that overestimated their performance gave tPA less often than other hospitals. The number of stroke patients treated at a hospital was a major factor in whether hospitals overestimated their performance in providing appropriate treatment. Hospital size or region did not appear to be significant factors.

“Institutions at any performance level could benefit from making protocol changes that would better align performance with perception,” lead author Cheryl Lin, MD, a former researcher at the Duke Clinical Research Institute in Durham, N.C., said in a journal news release. “This would have a significant impact on the quality of stroke care delivered across the United States.”


  1. Lin C et al. J Am Heart Assoc. 2015;doi:10.1161/JAHA.114.001298.