Situation
Stroke care has seen tremendous advances – when common standards for diagnosis, transport and intervention are employed between system and non-system partners.
If competitive barriers can be removed, there are tremendous opportunities to enhance care and produce better outcomes.
Background
In collaboration with Destination Health, the AMC designed and executed a telestroke service employing an electronic bunker with 24/7 stroke neurology coverage.
The ability to employ telestroke capabilities across a broad geographic area, coupled with an air and ground transport network, can offer unique outcome benefits.
The last element of this care network includes highly specialized neurovascular surgeons with the capability to perform advanced procedures for certain patients diagnosed and transported to centers of excellence in a rapid time window.
Execution
Based on the vision of what produces the best patient outcome, a neurovascular diagnosis and treatment network for strokes has been designed and implemented.
Unique aspects of this execution:
• The AMCs telestroke network is available to all hospitals in the state regardless of sponsorship or affiliation. This allows smaller hospitals to provide rapid stroke diagnosis by a stroke neurologist in their EDs and initiate protocol-based care that can include thrombolytic administration or rapid patient transfer.
• Specialty trained neurosurgeons are deployed at key locations with the ability to perform minimally invasive thrombectomies for clinically appropriate patients.
• A rapid transfer mechanism provides air and ground transport when a patient needs specialized intervention in a time-sensitive manner.
Results
One standard of care for strokes at any of 13 participating hospitals across the state with the ability to provide better outcomes.
A single standard of care.
Effective deployment of scarce and expensive resources through the advanced use of telemedicine and intervention.