Comprehensive & Primary Stroke Centers
What’s The Difference Where I Go For Stroke Treatment As Long As It’s A Hospital?
Not all hospitals are properly equipped or have the professional staff to treat stroke symptoms. It’s imperative to know which hospitals in your area are designated as:
And to know the differences between them.
Comprehensive Stroke Centers
A growing body of research shows that stroke victims receive better treatment and recover with fewer disabilities at comprehensive stroke centers. These centers give you or your loved one the best chance to survive and get back to normal living.
The professional organization that designates hospitals as “Comprehensive Stroke Centers” is The Brain Coalition, made up of:
- American Academy of Neurology
- American Association of Neurological Surgeons
- American Stroke Association, a division of the American Heart Association
- Centers for Disease Control and Prevention (CDC)
- National Institute of Neurological Disorders and Stroke
- National Stroke Association
To qualify as a Comprehensive Stroke Center a hospital must pass all the rigorous requirements set by The Brain Coalition.
- An Acute Stroke Team with training and expertise in stroke treatment must be available 24/7 in order to evaluate the arrival of any patient within fifteen minutes who may have suffered a stroke
- A certified neurosurgeon must be available 24/7 to provide Neurosurgical Services to stroke patients within two hours of when his services are needed
- The hospital must have written guidelines approved by The Brain Coalition for emergency treatment of stroke patients. These guidelines enable the immediate diagnosis and treatment of stroke patients, as instant stroke treatment is compulsory in order to eliminate – or minimize – complications.
- The hospital must be known by area Emergency Medical Services (EMS) or rescue squads as the best place to take patients suspected of suffering a stroke and how long it will take to arrive there. If the distance is too great. The patient will be rushed to a Primary Care Hospital initially.
- The EMS will be in constant communication with the hospital so the hospital will be prepared, with not an instant wasted, to begin treatment the second the patient arrives.
- The designated hospital’s Emergency Department is professional – trained to diagnose and treat stroke. Instant lines of communication are established between the EMS and the acute stroke team. Not a nanosecond can be lost in treating stroke.
- The hospital has accredited expertise in performing and evaluating brain imaging studies (neuroimaging via CT or MRI scan) within 45 minutes of time ordered. A specialist must be present 24/7 to interpret findings.
- Laboratory services must be available 24/7. Time is of the essence in treating stroke as any minute lost may mean the difference between life and death.
- Each Comprehensive Stroke Center must have a neurological intensive care unit where patients with brain trauma are treated exclusively, because they require minute-by-minute monitoring and care beyond those first life-threatening minutes.
Primary Stroke Centers
The American Heart Association advises that a patient be taken to a Primary Stroke Center first if a Comprehensive Stroke Center is too far away. There the patient will be stabilized and emergency care given until a transfer to a Comprehensive Stroke Center can be arranged.
A hospital qualifies as a Primary Stroke Center only when given certification by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
What is JCAHO and what gives them power to certify that a hospital meets quality standards?
- Members are individuals from the private medical sector who maintain standards of quality in U.S. medical facilities.
- The JCAHO has no official affiliation with U.S. government regulatory agencies, and has no legal enforcement power.
- Since many medical facilities rely on JCAHO accreditation, it has assumed importance in the medical field despite its lack of official government sanction.
- The National Institute of Neurologic Disorders and Stroke (NINDS), a division of the National Institutes of Health (NIH), has recommended that all U.S. hospitals promote their facilities for comprehensive stroke care.
According to the New Jersey Stroke Center Act, Primary stroke Centers are required to:
- Have acute stroke center teams in place at all times that can respond to a patient’s needs with 15 minutes of time of arrival
- Maintain neurology and emergency department personnel trained in the treatment of acute stroke
- Maintain telemetry or critical care beds staffed by physicians and nurses trained in caring for acute stroke patients
- Provide for neurological services within two hours either at the hospital or under agreement with a Comprehensive Stroke Center
- Provide care rehabilitation
- Enter into a written transfer agreement with a Comprehensive Stroke Center