Optimizing Stroke Care in the Dominican Republic: Early Insights from RES-Q
Stephanie Castro Turbi1, María Cedeño-Bruzual2, Marcos Brea Montes de Oca2, Diego Gil Troncoso2, Sabrina Lora2, Ruben Dario Bleubar Ozoria4, Francisco Méndez3, Edwina Luna Rodríguez1
1Neurology Department, 2Knowledge Management and Epidemiology, 3Emergency Department, Centers for Diagnostic, Advanced Medicine and Telemedicine (CEDIMAT), 4Instituto Tecnológico de Santo Domingo (INTEC)
Objective:
To describe the implementation of RES-Q in a Dominican Republic tertiary hospital and assess indicator trends, data-entry barriers, and team perceptions.
Background:
Stroke remains a leading cause of disability and mortality worldwide. Optimal use of effective therapies depends on adherence to quality standards. Standardized registries such as RES-Q support performance monitoring and continuous improvement in stroke care.
Design/Methods:
Observational mixed-methods study (March 2022-June 2025). Key treatment time metrics, and stroke admissions per quarter were extracted and compared from the RES-Q registry. An open-ended survey to clinical staff explored barriers, facilitators, and perceptions of the system’s usefulness, analyzed using thematic content and statistical analyses using STATA 19.0.
Results:
A total of 45 healthcare professionals across stroke care disciplines participated. Only 46.7% (n=21) were familiar with the RES-Q platform, and fewer than 60% of them had received specific training on its use. While most clinicians valued the generated data (92.3%, n=12), barriers to implementation included lack of time (66.7%, n=8) and insufficient feedback (46.2%, n=6). Nevertheless, respondents recognized its usefulness for improving care organization (84.6%, n=11), decision-making (30.8%, n=4), and treatment timelines (61.5%, n=8). The most frequent suggestions were enhanced training, regular audits, and structured feedback meetings. Patient enrollment in the RES-Q platform showed a steady quarterly and yearly increase after implementation. Performance metrics improved over time, with shorter door-to-imaging times (DIT) and more patients receiving reperfusion therapy, although door-to-groin (DTG) times for mechanical thrombectomy remained prolonged.
Conclusions:
Implementation of the RES-Q platform led to progressive adoption and measurable improvements in performance metrics, including shorter DIT and higher revascularization rates, while DTG remains above target. Limited awareness and training remain key barriers. Continuous education and institutional feedback mechanisms are recommended to strengthen adoption and sustain quality improvement.
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