The University of Louisville, UK HealthCare, the Kentucky Department for Public Health’s Heart Disease and Stroke Prevention Program (KHDSP) and other state partners have been awarded the prestigious Paul Coverdell National Acute Stroke Program Grant by the Centers for Disease Control and Prevention. This $1.8 million grant aims to optimize both stroke prevention among those at high risk as well as improve the care and outcomes for stroke patients throughout Kentucky.

The three-year grant will allow the coordination and expansion of existing efforts to improve stroke-related health outcomes. Kentucky health care systems and community providers will work together to implement comprehensive stroke systems for those at high risk for stroke and those who have had a stroke. 

“This program will allow expansion of our statewide efforts to serve rural and underserved citizens of the Commonwealth, to reduce disparities and monitor our progress,” said Kerri S. Remmel, chair of the UofL Department of Neurology, director of the UofL Hospital Stroke Center and co-chair of the KHDSP Task Force. “The program will facilitate continuous quality improvement in the full continuum of care from the moment a patient has a stroke through their emergency services, hospitalization and rehabilitation to their outpatient preventive care. We are extremely enthusiastic about collaborating with our partners in the Coverdell Program to improve stroke systems of care in Kentucky.”

“This award validates the voluntary efforts of stroke center personnel, EMS representatives, community partners, KHDSP staff and colleagues in public health, as well as all other stakeholders who have worked tirelessly across geopolitical boundaries in a collaborative effort to advance stroke systems of care in our state,” said Kari Moore, chair of the Stroke Encounter Quality Improvement Project (SEQIP) and project co-investigator. “We are excited to continue to build upon these efforts supported by the Coverdell award.”

KHDSP and SEQIP have made significant strides over the last 10 years improving stroke systems of care in the Commonwealth and growing access to stroke care by increasing the number of certified stroke centers in the state, increasing delivery of acute stroke treatments that can reverse or minimize stroke deficits and sharing best practices to help facilitate care delivery during hospitalization and after discharge.

This grant will coordinate and expand existing efforts in Kentucky to improve stroke-related health outcomes by working with Kentucky health care systems and community providers to implement comprehensive stroke systems for those at high risk for stroke and those who have had a stroke. 

The Coverdell award also will allow the group to target areas of the Commonwealth that are disproportionately affected by stroke, such as the Appalachian counties. The mortality rate due to stroke in that region is 14% higher than the national average and 8% higher than the rest of the state.

“This award could not come at a better time, because Kentucky has among the highest rates of stroke-related deaths in the country,” said Larry B. Goldstein, chairman of the University of Kentucky Department of Neurology and principal investigator on the project. “Over 2,000 Kentuckians die from stroke or stroke-related complications each year. Health behaviors and conditions that contribute to stroke are present at high rates in Kentucky with contributions from smoking, obesity, diabetes, hypertension, excessive alcohol use and physical inactivity. Although there are several existing stroke programs in Kentucky, we are excited that this project will coordinate and expand upon these efforts to improve stroke outcomes for Kentuckians.”

As part of the Coverdell initiative, the Kentucky Stroke Improvement Cooperative (KSIC) will be created to provide leadership for improving the quality of stroke care in the Commonwealth. Building from the KHDSP Taskforce and SEQIP, the UK and UofL Stroke Programs and the SCN, this group will lead the collaborative effort to transform Kentucky’s stroke care and outcomes by improving health approaches and practices.

Since its inception in 2005, The Coverdell Program has funded programs to ensure that all Americans receive the highest quality stroke care, a leading cause of death and long-term disability, by supporting coordinated stroke systems of care.

Joining nine other states currently funded by the Paul Coverdell National Acute Stroke Program, Kentucky’s program will:

• Increase access and participation in the statewide Kentucky Heart Disease and Stroke Prevention Task Force from the current 38 hospitals to help close the gap in stroke care for high burden populations. In addition to focusing on hospitals, the project will expand participation to encompass the community, primary care clinics, EMS, rehabilitation centers and long-term care facilities.
• Expand coordination between existing programs including the Kentucky SEQIP, the statewide UK/Norton Healthcare Stroke Care Network, and the 36 certified stroke centers in Kentucky.
• Increase access, understanding, utilization, and compliance with evidence-based performance measures of the American Heart Association’s Get With the Guidelines Stroke Program.
• Expand existing systems of care to coordinate and extend access to rural and underserved populations.
• Increase the dissemination of evidence-based guidelines for improvement of hypertension, obesity and diabetes control, which are the leading risk factors for stroke disproportionately affecting high-burden populations.
• Reduce stroke disparities and deaths over the long term and improve outcomes throughout Kentucky with a focus on Appalachia and underserved communities at highest risk.