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Did you know?

Stroke is the 3rd leading cause of death and one of the major causes of long-term disability.

Industry trends reveal that Stroke care is the new ‘up and comer’ service, quickly moving onto the radar for many hospital leaders. As a result of growing consumer need because of an aging population, greater awareness prompted by the focus on stroke education and prevention, and interventional trends in the news, Stroke Centers are the latest boom for strategic hospital expansions. With nearly 700,000 strokes occurring each year, savvy hospitals must find ways to provide the most effective care for this patient population while optimizing space, expert staff, and existing clinical infrastructure.

Stroke as a leading cause of death and disability in the US is an indisputable fact. But…Has the healthcare system failed this patient population? Have we become complacent in our approach to care, accepting the expensive costs of lifelong disability and long-term care?

Corazon believes that it’s time to change the stroke care paradigm …

The development of Primary Stroke Centers that advocate early recognition, rapid diagnosis, and timely intervention are on the forefront of a new approach that must be embraced nationally in order to significantly improve not only the quality, but also the availability, of stroke care.

As of the time of this writing, there are 533 Primary Stroke Centers accredited by the Joint Commission in the US, which is nearly double the documented number from just two years ago (218 in 2006). Florida leads the pack with 68 accredited programs. One would speculate that Florida hospitals are ahead of the curve because of the large elderly population. Or, perhaps the driving force behind accreditation is fueled by regulations that stipulate that EMS services must triage patients with stroke symptoms to an accredited stroke center. Currently, Florida, California, and Massachusetts have state-mandated regulations for stroke transports.

Corazon recommends that organizations not wait for regulations, but instead proactively reorganize care and resources to do what is in the best interest of the patient and the community at large. There is no denying that some form of organized stroke care is necessary for a hospital to make an impact on the health of the community. Clearly, the role for community and mid-sized hospitals is expanding.

Indeed, there are vast similarities between stroke care and heart care, which allows hospital professionals to transfer their skills to this growing sub-specialty. The greatest similarity between a ‘heart attack’ and a ‘brain attack’ is the need for immediacy of an intervention. These acute patients follow a parallel track from admission, through discharge, to follow-up and/or rehabilitative care. Principles that have been hard-wired into the care of the cardiac population can be modified and duplicated for the care of the stroke population. Learning from cardiac program implementation histories and capitalizing on a faster organizational learning curve can be possible with diligent planning efforts.

But, in today’s challenging world of limited access to capital, it is Corazon’s belief that hospitals must critically evaluate their options for the development of a comprehensive stroke program. We recommend the below strategies for ALL hospitals – those just beginning to organize stroke services and others seeking to improve care delivery in this clinical area.

Strategy #1: Maximize existing resources. Creative and strategic thinking is essential. Our team often finds that sophisticated cath suites often have capacity to take on neuro-interventional services. Also, highly-skilled cath teams can be trained to learn new skills that allows for greater cross-over in terms of clinical care delivery.

Strategy #2: Organize a collaborative team. Regardless of stroke program size or scope, committed administrative and physician champions are key. Bringing together savvy leaders who can wade through challenging implementation issues and make decisions in the best interest of the patient and the hospital can be the basis for ensuring success. The development of a Stroke Program cuts across many hospital departments and specialties. In fact, comprehensive Stroke Centers can involve some or all of the following disciplines:

  • Neurology
  • Neurosurgery
  • Interventional Neurology
  • Interventional NeuroRadiology
  • Cardiology
  • Service Line Leaders

Strategy #3: Optimize outreach initiatives. Corazon believes there are significant opportunities for hospitals to leverage the dollars they spend in education for the public about risk modification and Stroke symptom recognition. While many organizations focus community education on the signs of a heart attack, many patients don’t know when they’ve had a stroke. A well-designed community and physician education strategy can be valuable for improving the level of care, while also serving as a differentiator.

The opportunity for hospitals is great. With the majority of stroke patients presenting at non-tertiary facilities, leading-edge communities can take advantage of the clinical, financial, and market benefits of implementing a Stroke Program or Center.