STROKE VICTOR SOLUTION –
Develop a Stroke Readiness Plan which includes at a minimum understanding the signs of stroke – F.A.S.T. and if it appears that there are stroke symptoms, then know where to go, in detail. WHY? “All hospitals are not created the same”.
You, your spouse, partner or other community member has a Stroke. You want to go to a hospital with a certified Stroke Unit “with as many of the bells and whistles as possible”. But just what does that mean? And where are they in your geography?
It means the stroke team has neurosurgeons, neuro-interventional radiologists, board certified neurologists and emergency physicians, and stroke certified registered nurses as leaders in stroke diagnosis, management, treatment and rehabilitation. You have to know that. In Florida for example, this is a Comprehensive Stroke Center, or whatever they call it in your geography. And as a Plan “B” you want to know where the nearest Primary Stroke Center is located.
This can be quite complicated and you may not want to solely rely on EMS to make the location decision.
The difference between the two types of centers is the amount and type of interventions that the hospital can provide. The Comprehensive Center, of which there are only about thirty in Florida, can provide the fullest range of interventions. The Primary Center, of which there are more, can provide some, but not all interventions. At larger hospital systems one location may be certified as a Comprehensive Center, while other locations are certified as Primary Centers, and then other locations may have no certification at all. Beyond a shadow of doubt, some is very much better than none.
Then there are different certifications. There are State Certifications and there are Joint Commission (JCAHO) certifications. The JCAHO certifications are voluntary so many of the State Certified Stroke Centers have not chosen to participate. In Connecticut there were 22 Primary Stroke Centers certified by the Connecticut Health Department but only 9 of them were JCAHO certified. Their website states,
“The Joint Commission accredits and certifies more than 20,500 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.”
As Part of the Plan you might want to consult your Family Physician or Internist knowing these designations. An informed patient is always appreciated and likely to be more successful!
For more details and other aspects of a Readiness Plan please consult my forthcoming book, Stroke Victor, How to Go from Stroke Victim to Stroke Victor.