1. Market share. Hospitals should evaluate the market share for stroke to identify gaps or surpluses of services in the community. This evaluation can help hospitals predict the potential volume for a stroke center and whether the hospital could compete with other local healthcare facilities. Dr. Shephard says hospitals can typically break even on a stroke center with approximately 100 to 150 ischemic stroke patients annually.
2. Staffing and leadership. One of the major challenges of developing a stroke center is recruiting and retaining skilled specialists, staff and leaders. When committing to building any neuroscience program, “The personnel become more difficult to find and more expensive,” Dr. Shephard says. “People who want to go develop neuroscience programs should understand neuroscience professionals are hard to find and hard to keep, because they’re in short supply and high demand. They can go anywhere; if they’re not happy, they will.”
Administrative leadership of the center and service line also need to be knowledgeable in clinical neuroscience. For example, Dr. Shephard says it would be difficult for a women and children’s executive to quickly transition to serving as a neuroscience executive. “Having clinical expertise in neuroscience facilitates better communications with physicians and staff and enhances the ability to recruit high level professionals through clinical connections. As an example, the American Association of Medical Administrators in now developing a College of Neuroscience Administrators to help meet the growing demand for this type of executive expertise,” he says.
3. Equipment. The complexity of neuroscience means that the technology can be quite expensive. Hospitals should consider whether the potential volume of stroke patients will outweigh capital costs for equipment. While a cardiac interventional suite may cost around $1 million, a neuro biplane suite may cost between $2.5 million and $4.5 million, according to Dr. Shephard.
4. Other service lines. Stroke patients can benefit hospitals financially because their needs cross into several different service lines, including surgery, radiology and rehabilitation, according to Dr. Shephard. Hospitals should coordinate patients’ care so they can access each service easily. In addition, many stroke patients enter the hospital through the emergency department. Hospitals should thus develop protocols for delivering the appropriate care to stroke patients in the ED in the fastest and safest way possible, much like the STEMI cardiac models many facilities use.
5. Standards. Stroke centers need to meet certain clinical standards to be competitive. Beginning Jan. 1, 2013, hospitals and health systems will be required to report on eight measures related to stroke care for the CMS Inpatient Quality Reporting Program. If data is not reported, hospitals may receive reduced reimbursement beginning in 2015. However, these eight measures are only a fraction of metrics stroke centers should track to gain market share and compete with other hospitals. ED performance measures, for instance, can affect the success of a stroke center because the ED is essential in coordinating the diagnosis and potential transfer of complex neuroscience patients.
More Articles on Hospital Neuroscience:
Saint Thomas Hospital in Tennessee Opens First-of-its-Kind Neurosurgical Center
9 Steps for Hospitals, Health Systems to Build a Neuroscience Center
Orthopedics, Neuroscience Center Opens at Illinois’ Memorial Hospital
