Vascular
Posted on: Oct 08
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Tags: stroke, neurology, certification, pathway, article

Neurological Interventions at a Primary Stroke Center

It’s important not only to be able to recognize the signs of stroke, but also to know the best place to go when those signs occur. Primary Stroke Centers are hospitals recognized by The Joint Commission for consistently providing rapid and efficient medical care to stroke patients.

When stroke occurs, time lost is brain lost. Each hour that treatment fails to occur, the brain loses as many neurons as it does in almost four years of aging.1 Because of the effect this rapid loss may have, it is imperative for people experiencing a stroke to receive rapid and proper medical intervention at a facility recognized for a standardized method of care. 

Primary Stroke Certification and what it means for you

Rapid medical attention is critical in preventing further brain damage once stroke occurs. And collaboration within the stroke team is essential to identify people having a stroke and initiate the proper intervention. In a hospital certified as a Primary Stroke Center, this collaboration begins in the Emergency Department (ED), where staff members are uniquely trained and highly engaged in shortening the time to therapy. Once a stroke is identified, the ED begins a specific communication and treatment process that includes working with with a neurologist and an interventional neuroradiologist to determine the proper intervention. 

A person who is seen within three hours of an acute stroke may be a candidate for tissue plasminogen activator, or tPA, a blood thinner that works to dissolve the artery-blocking clot in ischemic stroke. This therapy is most effective in preventing further brain damage if administered within the 3-hour window. If the stroke team determines that the stroke occurred in the previous three to six hours, an interventional neuroradiologist may be able to retrieve the stroke-causing clot through a minimally-invasive catheter, lessening the damage caused to the brain. Primary Stroke Centers also have a hemorrhagic OR staff on hand ready to operate if needed.

Certified stroke centers not only provide rapid and efficient care, but also extend additional healthcare resources throughout the community. The use of smartphones in stroke telemedicine provides the expertise of a neurologist from a Primary Stroke Center to rural facilities lacking specified stroke teams. Imaging scans can be viewed over smartphones, allowing a neurologist to direct the ED staff on the most efficient intervention. Certain occasions allow for the neurologist to further assess the situation by speaking to the patient via a smartphone camera.

The Joint Commission and the certification process

The Joint Commission is an independent organization aimed to accredit healthcare organizations in an effort to improve patient care. Recognized nationwide, a certification by The Joint Commission is a symbol of quality and clinical excellence.

To be designated as a Primary Stroke Center, a stroke program must meet specific requirements and expectations set by The Joint Commission and based on recommendations from organizations such as the American Heart Association and the Brain Attack Coalition. These measures include a communication pathway that allow for efficient intervention on an individual basis, facilitation of individual therapy and intervention, patient self-management activity support, and the use of standardized performance measure data to continually improve practice guidelines.2 There are eight core measures that a stroke center must meet to obtain and maintain its certification by The Joint Commission:

Performance Measures of a Primary Stroke Center

  • Venous thromboembolism prophylaxis
  • Discharged on antithrombotic therapy
  • Anticoagulation therapy for atrial fibrillation/flutter
  • Thrombolytic therapy
  • Antithrombolytic therapy by the end of hospital day two
  • Discharged on statin medication
  • Stroke education
  • Assessed for rehabilitation

The certification process is a rigorous ongoing endeavor, as accreditation occurs every two years. An 8- to 10- person multidisciplinary team compiles data and enforces guidelines to ensure continued designation as a Primary Stroke Center by the Joint Commission.

Stroke is a medical emergency

Stroke teams recognize and emphasize that communication, collaboration and knowledge are vital in preventing further brain damage from stroke. Stroke is a medical emergency; therefore, it is imperative for everyone involved, including the general public, to know the signs of stroke as well as the benefits of the neurological interventions Primary Stroke Centers can provide to people who experience a stroke.

 

References:
1. Saver J. Time is brain-quantified. Stroke. 2006;37:263-266.
2. The Joint Commission. Facts about Primary Stroke Center Certification. Available at: www.jointcommission.org/assets/1/18/Facts_about_Primary_Stroke_Center_Certification.pdf Accessed April, 2012.

Tags: stroke, neurology, certification, pathway, article
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Neurological Interventions at a Primary Stroke Center

It’s important not only to be able to recognize the signs of stroke, but also to know the best place to go when those signs occur. Primary Stroke Centers are hospitals recognized by The Joint Commission for consistently providing rapid and efficient medical care to stroke patients.

When stroke occurs, time lost is brain lost. Each hour that treatment fails to occur, the brain loses as many neurons as it does in almost four years of aging.1 Because of the effect this rapid loss may have, it is imperative for people experiencing a stroke to receive rapid and proper medical intervention at a facility recognized for a standardized method of care. 

Primary Stroke Certification and what it means for you

Rapid medical attention is critical in preventing further brain damage once stroke occurs. And collaboration within the stroke team is essential to identify people having a stroke and initiate the proper intervention. In a hospital certified as a Primary Stroke Center, this collaboration begins in the Emergency Department (ED), where staff members are uniquely trained and highly engaged in shortening the time to therapy. Once a stroke is identified, the ED begins a specific communication and treatment process that includes working with with a neurologist and an interventional neuroradiologist to determine the proper intervention. 

A person who is seen within three hours of an acute stroke may be a candidate for tissue plasminogen activator, or tPA, a blood thinner that works to dissolve the artery-blocking clot in ischemic stroke. This therapy is most effective in preventing further brain damage if administered within the 3-hour window. If the stroke team determines that the stroke occurred in the previous three to six hours, an interventional neuroradiologist may be able to retrieve the stroke-causing clot through a minimally-invasive catheter, lessening the damage caused to the brain. Primary Stroke Centers also have a hemorrhagic OR staff on hand ready to operate if needed.

Certified stroke centers not only provide rapid and efficient care, but also extend additional healthcare resources throughout the community. The use of smartphones in stroke telemedicine provides the expertise of a neurologist from a Primary Stroke Center to rural facilities lacking specified stroke teams. Imaging scans can be viewed over smartphones, allowing a neurologist to direct the ED staff on the most efficient intervention. Certain occasions allow for the neurologist to further assess the situation by speaking to the patient via a smartphone camera.

The Joint Commission and the certification process

The Joint Commission is an independent organization aimed to accredit healthcare organizations in an effort to improve patient care. Recognized nationwide, a certification by The Joint Commission is a symbol of quality and clinical excellence.

To be designated as a Primary Stroke Center, a stroke program must meet specific requirements and expectations set by The Joint Commission and based on recommendations from organizations such as the American Heart Association and the Brain Attack Coalition. These measures include a communication pathway that allow for efficient intervention on an individual basis, facilitation of individual therapy and intervention, patient self-management activity support, and the use of standardized performance measure data to continually improve practice guidelines.2 There are eight core measures that a stroke center must meet to obtain and maintain its certification by The Joint Commission:

Performance Measures of a Primary Stroke Center

  • Venous thromboembolism prophylaxis
  • Discharged on antithrombotic therapy
  • Anticoagulation therapy for atrial fibrillation/flutter
  • Thrombolytic therapy
  • Antithrombolytic therapy by the end of hospital day two
  • Discharged on statin medication
  • Stroke education
  • Assessed for rehabilitation

The certification process is a rigorous ongoing endeavor, as accreditation occurs every two years. An 8- to 10- person multidisciplinary team compiles data and enforces guidelines to ensure continued designation as a Primary Stroke Center by the Joint Commission.

Stroke is a medical emergency

Stroke teams recognize and emphasize that communication, collaboration and knowledge are vital in preventing further brain damage from stroke. Stroke is a medical emergency; therefore, it is imperative for everyone involved, including the general public, to know the signs of stroke as well as the benefits of the neurological interventions Primary Stroke Centers can provide to people who experience a stroke.

 

References:
1. Saver J. Time is brain-quantified. Stroke. 2006;37:263-266.
2. The Joint Commission. Facts about Primary Stroke Center Certification. Available at: www.jointcommission.org/assets/1/18/Facts_about_Primary_Stroke_Center_Certification.pdf Accessed April, 2012.

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