Prasanthi Govindarajan, MD is exploring how county stroke bypass policies impact patient outcomes.

The Right Care at the Right Location

Prasanthi Govindarajan, MD is using a multi-year Research Project grant from the Department of Health and Human Services Agency for Healthcare Research and Quality to study the effect of state- and county-level stroke center bypass policies on patient outcomes. 

In a best-case scenario, pre-hospital providers quickly recognize stroke en route, and the patient is taken to a facility such as a primary stroke center that can rapidly administer the optimal treatment for that patient, even if it means bypassing a closer facility. 

From 2006-2014, only 896 counties in the United States had a stroke center bypass policy; twice as many did not. And among those with policies, there was wide variation in the process, implementation, and scope.

Working with partners, Govindarajan, an associate professor of emergency medicine, is using a mixed-methods approach to determine:

• if a bypass policy leads to an increase in intravenous alteplase and better stroke patient outcomes (lower 30-day mortality and greater short- and long-term functional independence); and

• if county factors (e.g., variation in policy components, urban/suburban/rural counties) are associated with differential effects on outcomes.

Govindarajan was recently invited by the Centers for Disease Control
and Prevention’s Division for Heart Disease and Stroke Prevention to serve on a national panel of experts developing guidelines for stroke systems of care.