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Mid America Stroke Network

Mid America Stroke Network. Founded By: Saint Louis University Hospital (SLU Hospital). The Mission.

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Mid America Stroke Network

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  1. Mid America Stroke Network Founded By: Saint Louis University Hospital (SLU Hospital)

  2. The Mission • Mission: Elevate the Quality of Stroke Treatment Within Outlying Communities by Collaborating with Community Hospitals and Offering Our Tertiary-Level Stroke Capabilities and Knowledge Within Those Local Communities. • Goal: Initiate a “Mid America Stroke Network” Utilizing a collaboration with SLUcare Physicians, Saint Louis University Hospital, and Multiple Community Hospitals. • Objective: For Appropriate Patients, Administer Tissue Plasminogen Activator (t-PA) Within 180 Minutes of Symptom Onset, Obtain a CT of the Brain and Interpret Within 25 Minutes of Arrival, and Assist the Outlying Hospitals in Monitoring and Elevating The Joint Commissions Standard Stroke Measures.

  3. The Spoke Hospital • Candidates Will Show a Commitment to: • Stroke Services and Community Benefit • Quality Monitoring and Focus • The Necessary Supporting Resources • Selected Candidate Hospital Will: • Embrace the American Stroke Association Protocols • Diagnose the Stroke Patient (ER or Neurology Physician) • Participate in a Dynamic Triage Process (Treat Internally within Capabilities, Transfer to SLU Hospital, or Transfer to Any Other Capable Hospital) • Evaluate Stroke Standard Measures/Indicators

  4. The Hub Hospital • SLUcare Physicians Will: • Respond Promptly to Consultation “Page” • Collaborate to Determine Best Treatment Outcome for the Patient • Request to View the Patient’s Physical Condition, Vital Assessment, and Images. • Discuss the Patient’s Response to t-PA Treatment • SLU Hospital Will: • Select Committed Stroke Partners • Collaborate to Establish Industry Leading Stroke Protocols • Provide support as a Joint Commission Certified Stroke Center for a higher level of care if needed

  5. 1st Year Results Clinical Results • Stroke specialists at bedside in 10 to13 minutes • 90 minute door to needle time • 80% of eligible patients received IV t-PA • 18 hospitals administered t-PA for the first time • 33% transfer to Hub for advanced care • 10% received interventional procedures • Average NIHSS scores • Admission = 10 • Discharge = 3

  6. The Transfer Process • Call SLU Hospital One Call Referral Number (1-866-491-0858) when a stroke patient presents • State you have a stroke patient and need to speak to the stroke neurologist • The SLUCare Stroke Neurologist will consult with the community hospital physician and help assess the patient • Outside Hospital pushes the radiology images to SLUH once completed • Outside Hospital calls for transport service if appropriate

  7. Candidates for Transfer • Who should be considered for transfer: Any acute ischemic stroke patient presenting within 0-12 hours regardless of whether they have received IV tPA. If a patient has received IV tPA, the recommendation is not to wait to see if the patient improves. If the NIHSS ≥ 10, transfer consideration is recommended. • What information do we need prior to transfer: Last time the patient was seen normal; non-contrast Head CT findings; NIHSS; pertinent labs (INR, creatinine, etc.); pertinent medical history if available; contact info of family to discuss treatment options (physician may be able to discuss with the family over the phone)

  8. Illinois Member Hospitals • Anderson Hospital • Fayette County Hospital • Franklin Hospital • Good Samaritan Regional Health Center, Mt. Vernon • Greenville Regional Hospital • Heartland Regional Medical Center • Herrin Hospital • Memorial Hospital, Belleville • Memorial Hospital, Carbondale • Red Bud Regional Hospital • Salem Township Hospital • St. Elizabeth’s Hospital • St. Joseph’s Hospital, Highland • St. Joseph’s Memorial Hospital, Murphysboro • St. Mary’s Hospital, Centralia • Sparta Community Hospital • Washington County Hospital

  9. Missouri Member Hospitals • Des Peres Hospital • Forest Park Hospital • Jefferson Regional Medical Center • Lincoln County Memorial Hospital • Mineral Area Regional Medical Center • Perry County Memorial Hospital • Pike County Memorial Hospital • Popular Bluff Regional Medical Center • Southeast Missouri Hospital • Ste. Genevieve County Memorial Hospital • Twin Rivers Regional Medical Center • Washington County Memorial Hospital

  10. The SLU Hospital Experience • Patient Need for Tertiary-Quaternary Level of Care: • Dial 1-866-491-0858 • Code Stroke Activated • Treatment Goals with High Validity and Reliability: • Tissue Plasminogen Activator (t-PA) 180 Minutes within Symptom Onset • CT within 25 minutes of Arrival • Immediate House Placement • Discharged Back to the Community is a Priority

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