When it comes to stroke, early assessment and rapid treatment are critical to saving brain cells — and lives.
To recognize hospitals for fast-acting care, the American Heart Association recently released its Get with the Guidelines awards. Vassar Brothers Medical Center, Putnam Hospital Center and Northern Dutchess Hospital each earned “Gold Plus” for following up-to-date, evidence-based treatment guidelines.
“We know that every minute counts,” said Dr. Paul Wright, Health Quest’s assistant vice president of neurosciences. “Faster access and treatment leads to an increased likelihood we can reduce the patient’s risk for death and disability, so this is an incredibly important healthcare initiative that is meaningful to our communities.”
The heart association’s evaluation is based on how well the hospitals provided brain scans, administered clot-busting drugs and prescribed preventive medications upon discharge, among other measures.
The type of award — gold, silver and bronze — relates to the length of time these practices were followed: two years for gold, a year for silver and 90 days for bronze.
The generalized categories of excellent care include: How quickly stroke patients were assessed, diagnosed and treated — and preventive treatments given throughout the patient’s hospital stay. A “plus” is awarded to hospitals that meet additional guidelines, such as cessation counseling for smokers, a major stroke risk.
At a “gold” hospital, highly trained emergency department staff are taught to spot stroke symptoms and act fast, according to Dr. Keyur Ajbani, medical director of Putnam’s emergency department.
A “code stroke” page is activated, sending a rapid-response stroke care team to the patient’s bedside within minutes.
“We draw blood for lab work, take a full medical assessment and prep the patient for a brain scan, if the patient wasn’t taken to radiology directly from the ambulance, which also occurs,” Ajbani said.
Here’s where “gold” is earned. Eligible patients must have clot-busting drugs within three hours of stroke symptoms.
“That can be tricky because not everyone heads to the Emergency Department immediately and because several tests are required before we can determine if the clot-busting medications are safe for the patient,” said Dr. W. Andrew Wilson, medical director of the emergency department at Northern Dutchess Hospital.
“For example, someone with diabetes, on a blood thinner medication, with consistent elevated blood pressure or internal bleeding may not be eligible. We must do a thorough assessment and have test results prior to our decision,” Wilson said.
For Vassar Brothers, which achieved honor roll status, more than half of those eligible patients received IV-tPa within an hour of arrival, “a significant achievement that requires stroke protocols to be streamlined to the second,” Wright said. A certified primary stroke center, Vassar neurointerventional surgeons also provide minimally invasive surgery using a catheter through the groin to retrieve and break up clots or to repair damaged blood vessels in the brain.
To earn “gold”, the association also requires:
- Patients receive medicines that slow down future clotting and prevent platelets from clumping within two days of their hospital stay and upon discharge.
- Physicians provide treatment to prevent complications such as clots in the lungs or vein.
- Physicians give patients with atrial fibrillation a blood thinner upon discharge.
“We are committed to delivering advanced and timely stroke care to patients in a safe and efficient manner, and this recognition is a testament to the level of care our team provides to patients,” Wright said.
To learn more about stroke care services at these Health Quest hospitals, visit healthquest.org/stroke.