South Florida Hospital News
Wednesday November 20, 2019

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October 2016 - Volume 13 - Issue 4




Multi-tiered Approach Earns Palmetto General Advanced Certification for Comprehensive Stroke Care

Palmetto General Hospital recently received Comprehensive Stroke Center certification from The Joint Commission and the American Heart Association/American Stroke Association. This designation makes it part of an elite group of providers focused on stroke care, and one of only two hospitals in South Florida, and one of only four in the state, to receive this honor. 

“This certification by The Joint Commission is the most difficult to get,” explained Ritesh Kaushal, M.D., medical director of the Comprehensive Stroke Center, Palmetto General Hospital. “It means that we are proven to provide the highest level of stroke care, based on our metrics, quality improvements, timing, interventions and outcomes - we have to meet very strict criteria.”
The Comprehensive Stroke Center certification recognizes hospitals that have state-of-the-art infrastructure, staff and training. The Joint Commission performs a rigorous on-site evaluation to ensure that the hospital meets all of its criteria, including having advanced imaging capabilities, 24/7 availability of specialized treatments, including endovascular intervention of stroke, and skilled staff with the competencies to care for complex stroke patients.
Palmetto also earned accolades for its door-to-needle (DTN) time, which Dr. Kaushal believes is the fastest in the state of Florida. “The national average for DTN is 76 minutes, and the average in Florida is 52 minutes,” he said. “Our DTN is 27 minutes; we’re basically twice as fast as other hospitals in Florida.”
Since Dr. Kaushal joined Palmetto General Hospital in 2013, he and other health care professionals have been working to decrease DTN times. “When I first came here, our DTN time was not the best; it averaged 72 minutes,” he said. “The following year, we got it down to 40 minutes, then 29, then 27.”
Dr. Kaushal credits the decrease in DTN to a number of factors, including the creation of a multidisciplinary stroke team that includes an ER physician, radiologist, interventionalist, stroke neurologist, nurse practitioner and ICU nurses.
“We identified the chokeholds - where we lost time - and worked on improving those,” said Dr. Kaushal. “We also partnered with EMS to decrease the time that it takes for us to respond to the report of a stroke.”
From the time that EMS units arrive at a patient’s home, they remain in constant contact with Dr. Kaushal. “This is incredibly important, because a person having a stroke is losing two million brain cells every minute,” he explained. “Once I receive word from EMS, I call my team in, so that we are all traveling to the hospital at the same time as the patient; this can save us 20 to 25 minutes. We can better prepare our equipment and personnel, which leads to excellent outcomes.”
Dr. Kaushal has also been provided with an emergency light for his car so that he can use the shoulder or emergency lane to get to the hospital more quickly.
Recognizing the signs of a stroke is also important, so Palmetto health care providers work within the community to provide education at fairs and in open health care forums. “We want to teach the community to recognize stroke symptoms faster, so that they call 9-1-1 faster,” explained Dr. Kaushal. “We are trying on every level to more quickly treat stroke.”

For more information about Palmetto General Hospital, call 1-800-522-5292 or visit

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