Systemization of advanced stroke care: the dollars and sense of comprehensive stroke centers
Therapies Friday, September 27th, 2013J NeuroIntervent Surg: 9/23/13
Stroke center designation is an integral component of maintaining the systems of care for cerebrovascular diseases.1 Organization of hospitals into efficient vehicles of healthcare delivery helps improve clinical outcomes.2 The approval of IV tissue plasminogen activator (tPA) for acute ischemic stroke (AIS) highlighted the need for specialized stroke centers able to quickly mobilize all aspects of care to administer this treatment, due to its strict time window of administration.3 ,4 This led to primary stroke center (PSC) designation. Just as with cardiac ‘STEMI’ (ST segment elevation myocardial infarction) centers, which have increased performance of life saving percutaneous coronary intervention for acute myocardial infarction,5,6 PSCs have increased IV tPA utilization.2 ,7 Treatments for cerebrovascular conditions using specialized procedures, such as cerebral aneurysms, require yet additional galvanization of resources. Criteria proposed for PSCs do not specifically mandate neurointerventional availability,8 but the success of the PSC designation process extended itself to designation of comprehensive stroke centers (CSCs) which would possess these (and other) capabilities.9 ,10A pathway for advanced accreditation of CSCs has been adopted by the Joint Commission (JC) for Hospital Accreditation.11 Read More