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.
2) System standardization: Eliminating variability in process and practice is key to improving stroke outcomes. To implement the degree of standardization necessary to elevate stroke care at the system level, administrative buy-in through investment in an interdisciplinary leadership team is needed. The role of the leadership team is to spearhead standardization across sites; define vision, goals, and benchmarks for participating sites; and identify needs and gaps in service to develop improvement initiatives.
3) Data-driven approach: A rigorous data-monitoring approach is the foundation to every successful stroke program. The utilization of a system-level scorecard or dashboard to share data across the system allows each entity to evaluate their performance, which is essential to identify areas to inflect change.
Participation in data collection programs, such as the American Stroke Association’s (ASA) Get With the Guidelines program, is another forcing function for establishing performance improvement, as this program allows organizations to benchmark stroke care against national cohorts and facilitates evidence-based practice sharing among participants.
4) Continuing education: The education of both clinical staff and the broader community is integral to improving stroke outcomes more generally. Organizations should implement standard education programs and materials to train clinicians on the systems, treatments, and needs of stroke patients so that the entire organization engages in the stroke program’s efforts. Additionally, top stroke programs conduct community-based education sessions to raise awareness of risk factors and the signs and symptoms of stroke.
5) Prevention: Innovative stroke programs have expanded the reach of their services, taking a longitudinal approach to managing high-risk patients. As hospitals and health systems recalibrate their emphasis from episodic care to population management, they need to ensure stroke risk factor management by providing ongoing care, counseling, and education both during the treatment of the initial episode and in ambulatory settings in follow-up to support risk modification in the long-term.
To learn more about multidisciplinary stroke care, please refer to the section “Promote Multidisciplinary Care” in the Council’s most recent publication, Neurosciences: Service Line Strategic Outlook.