Accreditation

JCAHO stroke center certification meets emerging standard

Briefings on Accreditation and Quality, April 1, 2005

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Editor's note: This is the first in a two-part series about JCAHO primary stroke center certification. This month's issue explains why it's important to have a stroke program and explores one medical center's experience building a stroke team. Next month we look at the medical center's experience with JCAHO, the results of the program, and how to start one at your facility.

A patient in her 50s experiences an acute stroke while recovering from surgery.

Because her physician is not a stroke specialist and the nurses present are not trained to care for an acute stroke patient, they are terrified. Should they give her a clot busting drug? No, she could bleed to death with that drug so soon after surgery. They quickly realize the situation is not something they can comfortably handle.

Then they remember who can handle it: the hospital's 24/7 stroke team. They call and mobilize the team, and within minutes stroke team members are on-site to evaluate and treat the patient.

"She went from total paralysis on the right side of her body, blind and not speaking, to needing only a brief stay on the rehabilitation unit and then being able to go home a few days after with only minor speech problems," says Tammy Cress RN, MSN, stroke program clinical supervisor and coordinator at Swedish Medical Center in Seattle.

Swedish is one of 93 JCAHO-certified primary stroke centers in the United States. Two of its campuses earned the designation in September 2004 after meeting the certification program's 10 core measures and demonstrating its stroke care for the accreditor during a September survey.

"It was very impressive," Cress says about the surgery patient her stroke team treated recently. "Can you say with absolute certainty that it would not have turned out the way it did before the program? No."

But the stroke team is treating about 600 patients annually in a state where stroke matches national statistics as the third leading cause of death, according to the Centers for Disease Control and Prevention (CDC). The program is in place to ensure that all patients are offered the same updated stroke treatment and management techniques, which dramatically improve each patient's ability to recover.

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