Why stroke certifications?
Jun 03, 2020 · In the event of a stroke, it may seem like the best hospital to go to is the closest one, but that’s not always the case. It’s important to go to a center offering the innovative technology, expertise, and infrastructure to stop the stroke in its tracks, minimize brain damage, and treat the underlying cause. You can find all of these features at a certified Comprehensive …
Do we need Comprehensive Stroke Centers?
Sep 20, 2021 · An area of active debate and research lies in the optimal prehospital strategy to transport stroke patients to the most appropriate stroke certified center. Timely transport and strategic coordinated treatment from lower to higher levels of definitive stroke centers can decrease tPA and mechanical thrombectomy times.
Does stroke care organization improve performance?
Here are just a few ways your organization — and your patients — can benefit from these innovative certifications: Designation for excellence in the care of stroke patients; Creates a loyal, cohesive clinical team; Assists organizations in establishing a consistent approach to care, reducing variation and the risk of error
Why designation for Excellence in stroke care?
This ensures specialized care for patients with even the most challenging strokes throughout the course of their diagnosis, treatment and recovery, at both the state-of-the-art inpatient hospital unit and the Stroke Prevention And Recovery Center (SPARC). Patients benefit from a range of comprehensive medical, surgical and minimally invasive treatment options, as well as access …
How does stroke certification support better patient care?
What does it mean to be stroke certified?
What is the goal of stroke care?
What does it mean to be a comprehensive stroke center?
When should the patient with an acute ischemic stroke receive antithrombotic therapy?
What feature is required for Primary Stroke Center certification?
Why effective stroke care is important to the management of stroke?
What are the acute treatment goals for stroke?
What is the role of the acute stroke team in a primary stroke center?
What is the difference between a primary and comprehensive stroke center?
Which patient is a candidate for fibrinolytic therapy?
What is the time goal for neurological assessment by the stroke team or designee?
What is a comprehensive stroke center certification?
Part of earning a Comprehensive Stroke Center certification includes experience in successfully performing procedures and treating certain types of strokes. This knowledge allows doctors to begin treatment immediately when a patient arrives because they’ve done it before.
What happens when a blood clot blocks an artery that normally delivers blood to the brain or a vessel
A stroke occurs when a blood clot blocks an artery that normally delivers blood to the brain or a vessel ruptures and bleeds. When the brain can’t access this oxygen-rich blood, its cells can experience permanent damage. The longer it goes without blood, the more damage occurs. Therefore, efficient care means more healthy brain cells survive.
Elevate Your Stroke Care
This program is designed for hospitals providing the critical elements to achieve long-term success in improving outcomes for stroke patients.
Meet the Unique and Specialized Needs of Stroke Patients
Offered in collaboration with the American Heart Association/American Stroke Association achieving Primary Stroke Center (PSC) Certification means you’re making exceptional efforts to foster better outcomes. It’s a signal to your community the quality of care you provide meets the unique and specialized needs of stroke patients.
Performance Measurement
Joint Commission-certified PSCs and organizations seeking initial certification are required to adopt a set of standardized performance measures. Organizations collect monthly data for each measure in the set. The data is then submitted quarterly to The Joint Commission.
Resources to Help You Get Started
Explore the standards, get checklists, tips and access the Review Process Guide.
Contact Us
Our team is here to help you with any questions you may have about certification.
What is the purpose of brain imaging after stroke?
Argye Hillis, M.D., and her team use brain imaging and functional assessments over the first year after a stroke to identify changes in blood flow in the brain and observe how different parts of the brain work together during different tasks.
What is the number to call for a stroke?
Request an appointment: 410-955-2228. A stroke is a medical emergency. If you experience these symptoms, please call 911 and go to the hospital immediately. Make sure you and your family can recognize the signs of a stroke, since prompt treatment means the best chance for optimal recovery.
What is the compliance score for the Heart Association?
Compliant: Compliance with the American Heart Association's "Get with the Guidelines" performance measures at or above 85 percent, better than the national benchmark.
Where is the Sheikh Khalifa Stroke Institute?
Created through a generous philanthropic gift from the United Arab Emirates (UAE), the Sheikh Khalifa Stroke Institute, with locations in Baltimore (U.S.) and Abu Dhabi (UAE), draws on Johns Hopkins’ vast leadership in stroke diagnosis, treatment and rehabilitation, including biomedical research;
Is Johns Hopkins Hospital a stroke center?
Johns Hopkins Stroke Center. The Department of Neurology at Johns Hopkins has two stroke centers certified by the Joint Commission and Maryland’s Emergency Medical Services Systems (MIEMSS), one at The Johns Hopkins Hospital and one at the Johns Hopkins Bayview Medical Center.
Why are comprehensive stroke centers important?
The argument strongly in favor of comprehensive stroke centers is based on the need for a higher level of specialized care given the spectrum of available diagnostic , treatment, preventive and rehabilitation resources, and new technical advents in these respective areas. Several studies have emerged that support the value of comprehensive stroke centers. For example, there may be a disparity between outcomes for stroke patients admitted to hospitals during weekends vs. weekdays. In one study comprehensive stroke centers showed no difference in 90-day mortality for stroke patients admitted on weekends vs. weekdays, whereas the risk of death if admitted on weekends at other care facilities was higher on weekends.82Furthermore, in a registry-linkage system study from Finland, the number-needed-to-treat to prevent 1 death or institutional care at 1 year was 29 for comprehensive stroke centers vs. 40 for primary stroke centers when compared to general hospitals.83A British study showed that stroke interventional endovascular services were available in only a small number of hospitals, and only about 50% of them who had no available endovascular service for stroke had transfer plans with a center that did provide the services.84
How does organized stroke care improve patient care?
Thus far, we have shown that organized stroke care in the form of enhanced medical delivery processes such as stroke units and primary stroke centers is associated with improvements in a number of performance measures, may be associated with reduced mortality and dependency, and other benefits. Emphasis on reducing medical errors and prevention of early rehospitalizations has become a major focus in the US healthcare system, and thus, highlights the need for systems of care that will reduce medical errors and complications. Given the potential for a high complexity of stroke case mix and the need to deliver cuttingedge interventions, a movement to establish comprehensive stroke centers has evolved. Comprehensive stroke centers are those capable of handling a full spectrum of care to seriously ill patients with stroke and cerebrovascular disease.81
How did race affect stroke care?
Based on 397,257 patients with ischemic stroke from 1,181 hospitals during the time period between 2003 and 2008, 7 performance measures were studied to determine differences in care according to race/ethnicity.61Overall, when compared to white patients, black patients were significantly less likely to receive intravenous thrombolysis, deep venous thrombosis prophylaxis, discharge antithrombotics, anticoagulants for atrial fibrillation, and lipid therapy, and of dying in the hospital. Hispanic patients received similar care and had similar mortality to white patients. Black and Hispanic patient length of hospital stay was higher than that of whites, but quality of care improved for each race/ethnic groups over time.61
What is primary stroke center certification?
In 2003 the AHA/ASA and The Joint Commission agreed on a certification process for stroke through a Disease-Specific Certification program that included a voluntary evaluation process driven by the demonstration of a consistent approach to clinical outcome measurement and minimum standards for stroke care built around acute ischemic stroke treatment with rtPA.4Primary Stroke Center Certification began in 2004 and by April 2005 about 15 hospitals per month were being reviewed.4By 2011, there were over 800 The Joint Commission primary stroke centers in the US out of some 4000-5000 total hospital facilities. Some states in the United States have established a state designation for stroke centers through a local health department certification mechanism, and in some regions legislation has been passed to have acute stroke patients bypass non-primary stroke center designated hospitals to allow diagnosis and treatment at primary stroke center-designated acute receiving hospitals.
What are the role of stroke performance measures?
Role and Value of Stroke Performance Measures. The implementation of stroke performance measures has been associated with large-scale improvement in stroke care.50Stroke performance measures primarily have emphasized acute and subacute aspects of stroke care, and thus, there is a need to expand the measures to be more inconclusive of outpatient stroke care and functional recovery. When the influence of patient and hospital factors are taken into account, in the Paul Coverdell National Acute Stroke Registry, hospital-level factors explained about 18% of total variation in quality of care, whereas the majority of variability in quality stroke care was accounted for by patientlevel factors (82%).51
What is the Get With The Guidelines Stroke program?
Carrying out an original systematic review and meta-analysis of the evidence supporting the value of primary stroke centers is beyond the scope of this review. Therefore, we will limit our discussion to select studies known to the author. An important aspect of organization of quality stroke care is the availability of a database solution to track outcomes and make improvements to care based on ongoing data analysis and checks.15The AHA/ASA Get With The Guidelines-Stroke (GWTG-S) program provides such a data solution and has been utilized by over 1,000 hospitals in the US and has over 1 million patient records. GWTG-S serves as a national stroke registry and quality improvement program and is believed to be representative of the national fee-for-service Medicare ischemic stroke population.16In a recent review of metric compliance and improved patient-centered outcomes in stroke, it was concluded that there are limited high-quality studies and methodologic flaws exist making it difficult to interpret the reported associations.17Furthermore, the possible importance of residual confounding in the study of hospitalized stroke patients in relation to the influence of compliance with guideline-based processes on risk-adjusted mortality and adjustment for stroke severity have been emphasized.18,19
What is stroke center designation?
Stroke Center Designa tion and Quality Improvement. Stroke center designation has been associated with a number of quality improvements including but not limited to access to timely thrombolytic therapy and utilization of stroke unit care.37Primary stroke centers may be established successfully as a metropolitan-wide matrix in large population areas to facilitate diagnosis and treatment of acute stroke patients.38Organization of acute stroke in this way may be advantageous especially when there is high annual hospital volume or high physician patient volume in relation to stroke care which heightens preferable outcomes or cost savings.39,40An organized stroke care system such as an inpatient stroke unit has been associated with reduced length of care and case fatality, cost-effectiveness when followed by early supportive discharge, and as a model for stroke care, generalizeability if implemented in non-principal referral hospitals.41-43It should be noted that there is evidence to suggest that primary stroke center designated hospitals had better outcomes than non-certified hospitals before The Joint Commission (TJC) program for primary stroke center designation was implemented. Possibly, the certified hospitals had organizational programs already in place prior to achieving certification status.
Why is time important in stroke care?
Because “ time is brain ,” patients without access to specialized care are in danger of potentially losing hundreds of neurons for each hour that stroke goes untreated. Teaching hospitals provide real-time access to specialized care via two-way audio and video links and electronic access to medical records, brain imaging, and lab results.
What is the role of teaching hospitals in stroke care?
Suffering a stroke can be a devastating, life-changing event for both patients and their families, but America’s medical schools and teaching hospitals provide increasingly effective and innovative approaches to saving lives and improving quality of life after a stroke.
What is neuro intensive care?
Neurological/Neurosurgical intensive care units (neuro ICUs). Neuro ICUs are staffed by highly specialized physicians, nurses, and other clinical staff who have training and vast experience in caring for complex neurology and neurosurgical patients. These units provide immediate access to intubation and emergent brain decompression kits, and give 24/7 access to the specialized staff needed for life-threatening neurological emergencies. Almost 90% of the hospitals in the United States certified by the Joint Commission as Advanced Comprehensive Stroke Center Hospitals are teaching hospitals. 1 This certification status requires a wide array of the most advanced personnel and technology resources to be available around the clock.
How long does it take for a stroke to respond to thrombectomies?
In two studies published in 2018, physician-scientists from Stanford University (CA), University of Pittsburgh (PA), and Grady Memorial Hospital (VA), reported that certain groups of stroke patients responded well to thrombectomies (surgical removal of blood clots) up to 16-to-24 hours after stroke symptoms appeared.
What is the stroke belt?
Researchers have found that some groups in rural and outlying communities comprised primarily of older persons, minorities, and those living along the so-called Stroke Belt — a 10-state region where stroke rates are higher than the general population — often lack immediate access to highly specialized stroke resources or to a general neurologist.
How long after stroke can you function independently?
The studies found that patients in trials addressing certain kinds of blockages and who received “late” thrombectomies were half as likely to die and more than 3.7 times as likely to be functioning independently 90 days post-stroke compared to patients who just received the clot-busting drug tPA.
Why are teaching hospitals important?
Because teaching hospitals are typically larger and tend to higher volumes of very ill and medically complex patients, they can invest in costly but important resources such as personnel, facilities, and equipment. These specialized resources improve the quality, safety, and outcomes for most medically vulnerable patients.
Primary Stroke Center (PSC)
Primary Stroke Center Certification recognizes hospitals that meet standards to support better outcomes for stroke care. Standards include:
Comprehensive Stroke Center (CSC)
Comprehensive Stroke Center Certification recognizes hospitals that meet standards to treat the most complex stroke cases. Standards include all components of a Primary Stroke Center plus: