Despite the proliferation of Joint Commission-certified primary stroke centers, there is still ample room for improvement in the medical management of stroke—only a small percentage of stroke patients receive treatment within the “golden hour” time window. Among the 800 certified stroke centers, only a handful have the resources to provide advanced neurointerventional services and be considered, unofficially, a “comprehensive” stroke program.
The Joint Commission has recently proposed more stringent requirements for comprehensive status that would formalize the designation that current “comprehensive” stroke programs have claimed.
As previously featured in Technology Insights' blog, The Pipeline, the new criteria would specify the infrastructure, technology, staffing, and services needed to receive designation as a “comprehensive stroke center.” Under the proposal, comprehensive stroke centers would no longer be defined at the procedural level, but rather by their ability to manage stroke care longitudinally, leaving many organizations out of the running for designation given the higher barrier to entry.
Reassessing development of comprehensive stroke programs
Developing a multidisciplinary stroke service is an emerging imperative for institutions looking to drive outcome improvements and extend patient care coordination across the broader continuum. Multidisciplinary care consists of the following components:
1) Interdisciplinary team structure: The ideal model includes:
- Medical director
- Clinical stroke coordinator
- Vascular neurologists
- Neuroscience nurses
- Rehabilitation specialists
- Operations coordinator
The collaborative nature of this type of stroke services allows the clinicians to develop a robust and individualized, nuanced treatment plan for each patient. Previous research has shown that such models result in incremental improvement in both outcomes and patient satisfaction by facilitating streamlined decision making and standardization of processes and goals.
Five essential elements of multidisciplinary stroke teams