SEATTLE, Nov. 4, 2004 - The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has notified Swedish Medical Center that its First Hill and Providence campuses have been certified as Primary Stroke Centers. To date, only 39 of the 5,764 hospitals in the United States have earned this designation. Swedish is the first medical center in western Washington to receive certification and only the second in Washington state. (Sacred Heart Medical Center in Spokane is the other.)
Stroke is a type of vascular disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel carrying oxygen to the brain is either blocked by a clot or bursts. According to the American Stroke Association, stroke is the No. 3 killer of Americans and the No. 1 cause of disability. Nearly 700,000 people suffer a new or recurrent stroke each year and almost 165,000 die of the condition.
"Stroke treatments are complex, rapidly evolving and far from perfect," said William Likosky, M.D., director of the Stroke Program in the Seattle Neuroscience Institute at Swedish Medical Center. "Patients suffering stroke need to get to a hospital very quickly and then around 80 different things need to be done to them. That takes an enormous amount of effort and coordination."
Until last year, no standardized set of nationally recognized performance measures for stroke treatment existed. JCAHO established that measurement set using criteria developed in conjunction with the American Stroke Association.
Achieving Primary Stroke Center certification involved training and coordinating care with many Swedish personnel, including emergency physicians, surgeons, neurologists, nurses, therapists, laboratory and pharmacy staff, radiologists, and even patient transporters. To be certified, among other things, Swedish had to demonstrate to JCAHO examiners that the medical center:
- Created and trained a Stroke Team that was available around the clock, seven days a week to evaluate a stroke patient within 15 minutes of arrival
- Developed and demonstrated consistent use of extensive written guidelines for emergency treatment and routine management for all stroke patients
- Always had a neurosurgeon available
- Had the capability to perform and interpret either a head CT scan or a brain MRI scan within 45 minutes of the stroke patient being admitted
- Had a fully functioning medical laboratory open 24/7
- Was able to provide coordinated stroke care beyond the emergency department physician's evaluation
- Provided Stroke Center staff with at least eight hours per year of continuing medical education
- Tracked patient outcomes, performed ongoing program evaluation and strived for improvements
- Conducted at least one annual program to educate citizens about stroke prevention, diagnosis and the availability of acute therapies
"Having a concrete goal in mind made it much easier to develop an integrated stroke treatment system," Dr. Likosky emphasized. "That's the real value of the JCAHO national standards."
"We then took these goals and implemented a program that has a stroke (nurse) consultant see each stroke patient during their hospital stay," said Stroke Program Clinical Supervisor and Coordinator Tammy Cress, R.N., M.S.N. "This helps us to personalize care for every stroke patient as we are actively involved in each case."
Over the past several months, Dr. Likosky and Cress have worked with Harborview Medical Center and other local emergency medical system providers to better coordinate stroke response and treatment.
"Ultimately, we would like every major hospital in the Puget Sound area to be a certified stroke center," Dr. Likosky said. "That's critical because we live in a recognized 'stroke belt' where there are more fatal strokes than in many other parts of the country."
Part of Swedish's public-education efforts involve communicating the warning signs of stroke. They include sudden numbness or weakness in the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and sudden, severe headache with no known cause. Any of these symptoms should prompt an immediate call to 911.
Dr. Likosky noted that some of the primary risk factors for stroke are high blood pressure, lack of exercise, obesity, use of tobacco and a high fat/low fiber diet. People in higher-risk categories include older adults, those with a family history of stroke, African-Americans and people with diabetes. For more information on stroke, contact the American Stroke Association at www.strokeassociation.org, visit www.swedish.org or call the Swedish Stroke Program office at 206-215-3958.
Swedish Medical Center is the largest, most comprehensive, nonprofit health provider in the Pacific Northwest. It is comprised of three hospital campuses (First Hill, Providence and Ballard), Swedish Home Care Services and Swedish Physicians - a network of 11 primary-care clinics. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiac care, oncology, orthopedics, high-risk obstetrics, neurological care, sleep medicine, pediatrics, organ transplantation and clinical research. For more information, visit www.swedish.org
- To listen to a related story that KPLU Radio (88.5 FM; National Public Radio) aired Monday morning, Nov. 15, 2004 click here (Windows Media Player required; free download available.)