Partnering with community hospitals to share expertise was the driving force behind Saint Thomas Health Services’ (STHS) decision to create the Saint Thomas Stroke Network in the last quarter of 2009. The community affiliations have grown organically out of relationships built by the Chest Pain Network. “The plan is to provide complimentary services because stroke and heart attack are both emergency disorders and are both on a timeline,” explained Michael Kaminski, MD, medical director for the Stroke Network.

The triple board certified neurologist is a stroke specialist who is clearly passionate about ensuring the standard of care is available to all by instituting recognized best practices. He said the Stroke Network’s mission is to bring community hospitals to the point of ‘stroke readiness.’

“The Saint Thomas Stroke Network was created in an effort to provide patients across the region with a streamlined approach to advanced stroke care — from early recognition of stroke-like symptoms to prompt diagnosis, treatment and transfer,” said Kaminski.

The Stroke Network provides onsite analysis and consultation, creates and reviews protocols, monitors clinical approaches, provides process improvement/quality programming, supports community outreach, and provides onsite education for Emergency Department staff, first-responders and physicians. Led on the ground by Stroke Network Clinical Coordinator Amy Howard, drills help healthcare professionals gage just how ready they are to help stroke victims. “Moving patients, especially those living in remote areas, through the stroke system quickly and efficiently is critical to saving more lives and limiting disabilities,” she said.

It’s a concept in which a number of area hospitals clearly believe. In mid-February, NorthCrest Medical Center announced its affiliation with the Saint Thomas Stroke Network. The Robertson County facility joins Cumberland Medical Center, Lincoln County Medical Center, Decatur General Hospital, Henry County Hospital, Hickman Community Hospital and the three STHS hospitals in the Nashville metro area — Baptist, Saint Thomas and Middle Tennessee Medical Center — as part of the rapidly growing network. Several other regional hospital facilities are in various stages of network development.

Kaminski said that each affiliated community hospital has slightly different needs. “We’re trying to customize this network approach to the hospital’s needs and specific patients’ needs … not just moving them downtown.” In fact, he continued, many patients could and should stay in their home community where family support systems are in place. “The idea is to move patients only when we can add value to them.”

Kaminski and his clinical team are focused on filling gaps so that each community … not just the hospital but also EMS units … is prepared to handle stroke victims according to protocol. “We try to bring the hospitals to stroke readiness,” said Kaminski, adding the goal isn’t to turn them into primary stroke centers like the three largest STHS hospitals in Nashville and Murfreesboro. Instead, Kaminski said the goal is to make sure the facilities could administer tPA (tissue plasminogen activator), the thrombolytic agent proven to be effective in treating ischemic stroke within the first three hours after onset of stroke symptoms.

“We also give them options for alternative therapies beyond the three-hour window,” he noted. Kaminski added the Saint Thomas Stroke Network affiliates also have opportunities to participate in clinical trials. In fact, he said two new trials would be starting soon that would study options providing a window of at least eight hours for active intervention in the wake of a stroke.

Kaminski said STHS also plans to expand telehealth initiatives as it pertains to stroke and has worked to strengthen the infrastructure of the primary stroke centers, which handle more complicated cases, as the network expands.

Although ‘stroke ready hospital’ is not an official accreditation, Kaminski said the American Heart Association has begun to explore the possibilities. Ultimately, he said he would like to see three levels of stroke care — stroke ready hospital, primary stroke center, and comprehensive stroke center. The latter would provide interventional stroke care around the clock. Although the Joint Commission isn’t certifying comprehensive centers at this point, guidelines do already exist for the designation. For Kaminski, it’s all about customizing stroke delivery and maximizing resources.

“When you customize the program, the patient gets … in a timely fashion … the right care and access to the most advanced care that is appropriate for them,” he concluded.

Tags:

Bookmark:

Digg

Facebook

Technorati

Newsvine

Google

Related: