Designation of Stroke Centers and Stroke Care
Quality Improvement Process
ÎÎThe creation of primary stroke centers is recommended (I-B).
Notes: The organization of such resources will depend on local resources.
The stroke system design of regional acute stroke-ready hospitals and primary stroke centers
that provide emergency care and that are closely associated with a comprehensive stroke
center, which provides more extensive care, has considerable appeal.
ÎÎCertification of stroke centers by an independent external body, such as
The Joint Commission or state health department, is recommended (I-B).
Note: Additional medical centers should seek such certification.
ÎÎHealthcare institutions should organize a multidisciplinary quality
improvement committee to review and monitor stroke care quality
benchmarks, indicators, evidence-based practices, and outcomes (I-B).
Notes: The formation of a clinical process improvement team and the establishment
of a stroke care data bank are helpful for such quality of care assurances. The data
repository can be used to identify the gaps or disparities in quality stroke care.
Once the gaps have been identified, specific interventions can be initiated to address
these gaps or disparities.
ÎÎFor patients with suspected stroke, EMS should bypass hospitals that
do not have resources to treat stroke and go to the closest facility
most capable of treating acute stroke (I-B).
ÎÎFor sites without in-house imaging interpretation expertise,
teleradiology systems approved by the Food and Drug Administration
(FDA) (or equivalent organization) are recommended for timely review
of brain computed tomography (CT) and magnetic resonance imaging
(MRI) scans in patients with suspected acute stroke (I-B).
• When implemented within a telestroke network, teleradiology systems approved
by the FDA (or equivalent organization) are useful in supporting rapid imaging
interpretation in time for fibrinolysis decision making (I-B).
ÎThe development of comprehensive stroke centers is recommended (I-C).
Î
ÎÎImplementation of telestroke consultation in conjunction with
stroke education and training for healthcare providers can be useful
to increase the use of intravenous (IV) recombinant tissue-type
plasminogen activator (rtPA) at community hospitals without access to
adequate onsite stroke expertise (IIa-B).
ÎÎThe creation of acute stroke-ready hospitals can be useful (IIa-C).
Notes: As with primary stroke centers, the organization of such resources will depend
on local resources.
The stroke system design of regional acute stroke-ready hospitals and primary stroke centers
that provide emergency care and that are closely associated with a comprehensive stroke
center, which provides more extensive care, has considerable appeal.
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