Although new treatments are available to improve the clinical outcomes of stroke, many acute care hospitals lack the necessary staff and equipment to optimally triage and treat or transfer patients to appropriate facilities. For example, one of the most effective treatments for stroke is the administration of IV t-PA, a blood thinning medication, under the supervision of neuro-specialists. Despite the fact that IV t-PA has been documented to save lives, only 3-5 percent of stroke victims nationwide receive this medication, although studies that show nearly 40 percent of stroke victims are viable candidates. Studies show that hospitals without 24/7 neuro-specialty coverage are much less likely to administer IV t-PA.
On May 19, the Illinois Senate unanimously passed HB 2244 amending Illinois’ Finance Act and Emergency Medical Services (EMS) Acts to provide for the development of a statewide EMS Region Plan for triage, treatment and transport of stroke victims. The new legislation directs Illinois’ director of public health to develop a working group to advise each of Illinois’ 11 EMS regions to develop protocols for handling stroke patients within each region. The new legislation also provides grant funding from the new “Hospital Stroke Care Fund” for the acquisition and maintenance of new infrastructure to support new stroke protocols including funding for personnel, equipment and pharmaceuticals for the diagnosis and treatment of stroke patients.
Illinois’ new law directs the director of public health to coordinate the recognition of “primary stroke centers” and “emergent stroke ready hospitals” throughout the state. While hospitals designated as primary stroke centers in Illinois will only be certified after receiving certification from The Joint Commission, Illinois has created a new category of emergent stroke ready hospitals that leaves the door open to participation and matching grant funding from the new Hospital Stroke Care Fund for profit and not-for-profit hospitals, including physician-owned hospitals.
The concept of a stroke network model has been adopted with varying degrees of success throughout the country with one of the more recent networks being formally launched and branded in Illinois. In 2007, the MidAmerica Stroke Network was launched by Saint Louis University Hospital (SLUH) and is now comprised of 30 hospitals in the Saint Louis and Southern Illinois Area with SLUH serving as the “hub” hospital. The MidAmerica Stroke Network serves as a model for Illinois hospitals considering participation in organized stroke networks; SLUH has worked with member hospitals and EMS to pioneer many aspects of standardized healthcare delivery during the “time-critical” period for stroke patients across the continuum of patient care.
Dan Kernebeck is principal and founder of Qual-Rx. Founded earlier this year, Qual-Rx has offices in Chicago and St. Louis, and its consultants have experience in helping hospitals attain The Joint Commission Primary Stroke Certification, as well in developing stroke networks such as the MidAmerica Stroke Network.
