Stroke Care

Acute stroke treatment must involve efficient processes of care to ensure the timely identification of stroke patients and the provision of optimal medical care to all stroke patients in the state.

Emergency Guidance to Stroke Centers during COVID-19

Temporary Guidelines
- Temporary Emergency Guidance to US Stroke Centers During the COVID-19 Pandemic
  
  American Heart Association and American Stroke Association

Strategies Related to Stroke Care by EMS

Develop state standards
Consider NC Stroke Care Guidelines to standardize quality care across the state
- 2019 Update to the 2018 Acute Stroke Guidelines
  
  American Heart Association and American Stroke Association
- Stroke Systems of Care: A 2019 Update
  
  American Heart Association and American Stroke Association
Consider state standards for EMS transport of stroke patients
- Enhancing EMS Care
  
  Genentech EMS education, routing, and outreach materials
- Outside ED Checklist for Code IA Stroke Cases & Transport Checklist for Code IA Stroke Cases
Support prehospital documentation and metrics
- Recommendations for Regional Stroke Destination Plans: A Consensus Statement
  
  Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference
- Suspected Stroke Protocol
  
  NC Office of EMS
Support provider education
• For Adult Stroke Care
- Advanced Stroke Life Support Course
  
  University of Miami
- American Association of Neuroscience Nurses
  
  Membership organization
- American Neurological Association
  
  Membership organization programs, training, podcasts
- Carolina Acute Stroke Training (CAST)
  
  Modules including Anatomy and Physiology, Emergency Management, Acute Ischemic Stroke Treatment, etc.
- Emergency Neurological Life Support Courses
  
  Protocols from the Neurocritical Care Society; click on calendar for classroom course listings
- Professional Education, Meetings, Guidelines and Statements
  
  American Heart Association and American Stroke Association
• For Pediatric Stroke Care
- An Update on Pediatric Stroke Protocol
  
  From Pediatric Emergency Care
- Carolina Acute Stroke Training (CAST)
  
  Module 9 covers Pediatric Stroke
- IAPS Educational Videos
  
  To raise awareness about pediatric stroke
- Improving Pediatric Stroke Diagnosis: Filling in the Gaps
  
  An article from Neurology Advisor
- Management of Stroke in Neonates and Children (2019)
  
  American Heart/American Stroke Association
- Pediatric Stroke Fact Sheets
  
  in English, Spanish, Portuguese International Alliance for Pediatric Stroke
- Pediatric Stroke: Diagnosis and Management in the Emergency Department
  
  From Pediatric Emergency Medicine Practice
- Pediatric Strokes: Parent and Family Guide
  
  UNC Pediatric Stroke Resource and Brochure
- Strokes Can Happen at Any Age infographic
  
  American Stroke Association
• From Industry
- Activase by Genentech
  
  Information on mixing and administration, education modules, outreach materials
- Medtronic
  
  Medical Technology provides resources for professionals
- Stryker
  
  Medical Technology offers professional training and education

Strategies Related to Stroke Care by Telestroke

Study telemedicine as a mechanism to provide stroke care
Determine telestroke services available in NC
- Telestroke Update
  
  Stroke Advisory Council meeting May 1, 2018
Identify resources for telestroke services
- NC Office on Rural Health
  
  Oversees the Rural Hospital Program and provides funds for telehealth to 20 hospitals (25 beds or fewer) to start telehealth programs
Identify the barriers to telestroke implementation

Strategies Related to Stroke Care by Hospital Systems

Support hospital stroke certifications (CSC, TSC, PSC, ASRH)
Clarify acute stroke guidelines
- Healthcare Facilities Accreditation Program
- Joint Commission Stroke Certification Comparison Grid
- Joint Commission Stroke Certifications
  - Comprehensive Stroke Center Certification (CSC)
  - Thrombectomy-Capable Stroke Center (TSC)
  - Primary Stroke Center Certification (PSC)
  - Acute Stroke Ready Hospital Certification (ASRH)
- Stroke Care Certifications
  
  DNV GL Healthcare
- Stroke Systems of Care: A 2019 Update
  
  American Heart Association and American Stroke Association
- Stroke-Certified Hospitals in NC
  
  Click on Designated Stroke Centers
Support hospital investment in Stroke Team
- Hire a Data Abstractor/Manager
  
  (Quality Nurse Specialist)
- Hire a Post-Acute Coordinator
- Hire a Stroke Coordinator
- Hire a Stroke Navigator
- Medical Director Position Statement
  
  American Academy of Neurology
Develop protocols
• For Stroke recognition
- ACLS Suspected Stroke algorithm course
- Activase by Genentech
  
  Information on mixing and administration, education modules, outreach materials
- Stroke Care and Recovery
  
  New Hanover Regional Medical Center’s Road Map to Stroke Care and Recovery
• For Triaging
- Activase by Genentech
  
  Information on mixing and administration, education modules, outreach materials
- Stroke Care and Recovery
  
  New Hanover Regional Medical Center’s Road Map to Stroke Care and Recovery
• For Workflow priority
- Activase by Genentech
  
  Information on mixing and administration, education modules, outreach materials
- IMPROVE Stroke Care
  
  Regional Systems of Care Best Practices Operations Manual
- Stroke Care and Recovery
  
  New Hanover Regional Medical Center’s Road Map to Stroke Care and Recovery
Determine diagnostic imaging needs
- 2019 Update to the 2018 Acute Stroke Guidelines
  
  American Heart Association and American Stroke Association
- 2022 Guideline for the Management of Patients with Spontaneous Intracerebral Hemorrhage
  
  American Heart Association / American Stroke Association
- Nuance PowerShare
  
  Network on medical imaging
- Stroke Systems of Care: A 2019 Update
  
  American Heart Association and American Stroke Association
- Viz.ai
  
  Artificial intelligence to synchronize stroke care
• Identify equipment needed for imaging and image sharing
• Identify protocols needed for imaging and image sharing

Strategies related to Stroke Care through Coordination

Partner with primary care, pharmacy, rehabilitation and human services to facilitate communication and collaboration
- Area Agencies on Aging (AAA)
  
  Regional support programs for older adults
- Community Pharmacy Enhanced Services Network (CPESN)
  
  Integrating pharmacists into the Medical Home Team
- NC Academy of Family Physicians
  
  Political action committee that represents the voice of family medicine
- NC Association of Pharmacists

Strategies related to Stroke Care Using Stroke Data

Collaborate with NC Health Information Exchange NC HealthConnex to build a Stroke Registry
- NC HealthConnex
  
  NC’s Health Information Exchange
- Progress in Stroke Prevention and the North Carolina Stroke System of Care
  
  From NC Medical Journal January-February 2024
Determine case data abstraction guidelines
- Get With The Guidelines Stroke Overview
  
  American Heart Association’s in-hospital program for improving stroke care by promoting adherence to the latest scientific treatment guidelines

Click on each of the five categories for strategies and resources.

prevention

stroke care

post stroke care