Commentary: Comprehensive Stroke Center Designations Matter

On February 12, 2022, MedPage Today wrote about the findings of Radoslav Raychev, MD, of the University of California Los Angeles, which were presented at the American Stroke Association International Stroke Conference:

“Stroke centers with advanced Joint Commission certifications did provide better care and outcomes for patients, the Get With the Guidelines (GWTG) stroke registry showed, and more and more hospitals appeared to be on their way to raising their status.

“Among U.S. hospitals offering reperfusion therapy to stroke patients, certified thrombectomy-capable stroke centers (TSCs) and comprehensive stroke centers (CSCs) both beat primary stroke centers (PSCs) for door-to-needle times, successful revascularization, and rates of in-hospital death or discharge to hospice on multivariable analysis.”

Certification Status Makes a Difference for Stroke Centers” by Nicole Lou, Staff Writer, MedPage Today. February 12, 2022

Tudor G. Jovin, MD

Tudor G. Jovin, MD, Medical Director of the Cooper Neurological Institute and an internationally renowned expert in the interventional and non-interventional treatment of stroke and cerebrovascular disorders, explained that this study’s results are not surprising. The rigors of The Joint Commission standards are meant to ensure the best in patient outcomes.

“It is widely acknowledged that achieving The Joint Commission’s certification as a Comprehensive Stroke Center means having achieved the highest standards in metrics and outcomes across a series of stringent requirements,” Dr. Jovin says. “Among these requirements are the 24/7 availability of thrombectomy capabilities, emergent open neurosurgical procedures, and advanced imaging. In addition to experts in vascular neurology and neuro critical care, the Emergency Department team, nurses, and other providers must also meet rigorous standards that ensure a comprehensive, system-wide approach to stroke care.”

At Comprehensive Stroke Centers like Cooper, having everything in place makes the difference in patient outcomes and translates to better care. Some of the metrics that are mentioned in the MedPage Today article include “door-to-needle times, successful revascularization, and rates of in-hospital death or discharge to hospice on multivariable analysis.”

“Door-to-needle is a metric that measures how quickly we can administer clot-busting drugs to a patient,” Dr. Jovin explains. “Door-to-access site puncture reflects how quickly after patient arrival to the hospital we can initiate thrombectomy and thus restore blood flow to the brain. Both of these metrics matter because it has been demonstrated that faster times mean a better outcome for the patient.

“Other metrics that matter include the number of patients that are discharged on the appropriate medication to prevent another stroke, or discharged to rehabilitation. What are the steps that are taken to follow up with patients to ensure they don’t fall through the cracks? What support systems are in place and what percentage of patients are given post-stroke care outside of medical interventions, such as physical therapy or speech therapy?”

The Joint Commission looks at the continuum of care for a patient, from pre-hospital care and ensuring the hospital is prepared to receive a patient, to entering the hospital, inpatient care, recovery, and post-discharge care. “There is no doubt that Comprehensive Stroke Centers like Cooper provide higher quality care for stroke patients, and these metrics are directly related to better patient outcomes,” Dr. Jovin says.

Tudor G. Jovin, MD 
Medical Director, Cooper Neurological Institute
Chairman and Chief of Neurology
Stroke Neurologist
Interventional Neurologist

Learn more about Cooper’s life-saving stroke care by listening to Judy’s story.



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