Improvements in stroke care already evident

June 21, 2000

Dallas, TX, June 21, 2000 -- A group of more than 75 hospitals across the nation have made substantial progress in improving stoke treatment, already acting on many of the recommendations of the Brain Attack Coalition published in this week's issue of The Journal of the American Medical Association.

The hospitals, participating in the Clinical Advantage program of the VHA hospital alliance, have shown a marked decrease in the time needed to accurately diagnose stroke patients based on CT scans. This significant improvement is enabling emergency room staff to more effectively administer clot-busting tPA treatment to eligible patients within the critical three-hour window from the time the stroke took place.

These results are due to an intensive focus on a number of processes used to evaluate and treat stroke patients, which include:"Timing and proper administration of tPA can mean the difference between life and death, recovery and disability. Through training of existing personnel -- neurologists, EMS staff, attending physicians, nurses, paramedics -- to rapidly respond as an integrated team in these potential situations, these hospitals are already achieving impressive results," said Marilyn Rymer, M.D., national chairperson of VHA's Clinical Advantage stroke initiative and medical director of the Stroke Center for Saint Luke's Hospital in Kansas City.

In the VHA initiative, participating hospitals have reduced the time it took from patients' arrival at the hospital to the interpretation of the CT scan from an average of 219 minutes to 115 minutes, a reduction of nearly 50 percent. Several hospitals -- including MedCentral Health System in Mansfield, Ohio; Fort Sanders Regional Medical Center/Covenant Health in Knoxville, Tenn.; and Union Regional Medical Center in Monroe, NC -- have reported getting their door-to-CT time down to an hour or less.

At Union Regional, the average time from door-to-CT is down to 35 minutes. Emergency room physician Dr. John Hartness, the hospital's stroke team champion, said the program has strengthened the hospital's work processes and protocols for dealing with stroke cases. For example, the hospital has been more aggressive in involving EMS and uses overhead pages for all staff involved. The key, he said, is preparation and organization. Clinicians at the 160-bed rural hospital have administered tPA 15 times since the program began in late 1999, a utilization well above the national average of 2-3 percent of stroke patients.

"It's evident that by focusing on what we know is most effective in treating stroke, and putting in place the processes to act on that evidence, hospitals can make dramatic improvements in patient care," said Stuart Baker, M.D., VHA executive vice president. "As reflected in the JAMA article, health care organizations can and should make these improvements, and I'm pleased we have a growing number of VHA member hospitals making this commitment."

Through VHA's Clinical Advantage, interdisciplinary teams at hospitals across the nation apply evidence-based methodologies, measurement tools and clinical information to improve patient care. The program is organized around specific medical conditions and a framework of resources to accelerate implementation, produce results and overcome barriers to change.

Currently more than 350 organizations and thousands of clinicians are participating in other Clinical Advantage initiatives to improve the treatment of breast cancer and heart attacks, and to reduce medication errors. Efforts to address congestive heart failure, patient safety, community-acquired pneumonia and end-of-life care are scheduled to begin in several regions during the next six months.

Kupper Parker Communications

Related Stroke Articles from Brightsurf:

Stroke alarm clock may streamline and accelerate time-sensitive acute stroke care
An interactive, digital alarm clock may speed emergency stroke care, starting at hospital arrival and through each step of the time-sensitive treatment process.

Stroke patients with COVID-19 have increased inflammation, stroke severity and death
Stroke patients who also have COVID-19 showed increased systemic inflammation, a more serious stroke severity and a much higher rate of death, compared to stroke patients who did not have COVID-19, according a retrospective, observational, cross-sectional study of 60 ischemic stroke patients admitted to UAB Hospital between late March and early May 2020.

'Time is vision' after a stroke
University of Rochester researchers studied stroke patients who experienced vision loss and found that the patients retained some visual abilities immediately after the stroke but these abilities diminished gradually and eventually disappeared permanently after approximately six months.

More stroke awareness, better eating habits may help reduce stroke risk for young adult African-Americans
Young African-Americans are experiencing higher rates of stroke because of health conditions such as high blood pressure, diabetes and obesity, yet their perception of their stroke risk is low.

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.

Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.

High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.

Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.

We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.

Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.

Read More: Stroke News and Stroke Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to