Target: Stroke Phase II Status
Target: Stroke Phase II is no longer ongoing—it has been succeeded by Target: Stroke III, which is the current active campaign as of 2024. 1
Evolution of the Target: Stroke Initiative
The Target: Stroke program has progressed through multiple phases:
Phase I (Completed)
- Goal: Achieve door-to-needle times ≤60 minutes in 50% of patients
- Outcome: Successfully met its goal by the end of the 3-year intervention period, reaching 53% of patients treated within 60 minutes 1
- Impact: Associated with lower rates of symptomatic intracranial hemorrhage, reduced in-hospital mortality, and greater likelihood of discharge home 1, 2
Phase II (Completed)
The goals you referenced—achieving door-to-needle times within 60 minutes in ≥75% of patients (primary goal) and within 45 minutes in ≥50% of patients (secondary goal)—were indeed the targets for Phase II. This phase was launched in April 2014 3 and has since concluded.
Phase II Results: By 2014-2015, hospitals achieved 59.3% of patients receiving tPA within 60 minutes and 30.4% within 45 minutes 3. The median door-to-needle time improved from 77 minutes (pre-intervention) to 67 minutes (post-intervention) 2.
Phase III (Current)
Target: Stroke III is the current active campaign and has expanded its scope beyond Phase II's objectives 1:
- Dual focus: Shorter door-to-needle times for IV tPA AND shorter door-to-device times for endovascular thrombectomy (EVT)
- Rationale: Building on the success of previous phases while addressing the growing importance of mechanical thrombectomy in acute stroke care
- Approach: Continues to develop and disseminate specific quality improvement tools and materials, now incorporating EVT metrics alongside tPA administration times
Clinical Significance
The progression from Phase II to Phase III reflects the evolving landscape of acute stroke treatment. While Phase II successfully pushed hospitals toward more aggressive door-to-needle time goals for thrombolysis, Phase III recognizes that comprehensive stroke care now requires optimization of both medical and interventional reperfusion strategies to maximize patient outcomes in terms of mortality, morbidity, and quality of life.