Many hospitals are developing or enhancing their stroke programs to better coordinate care and meet quality standards. There have been many examples of success, such as Palm Drive Hospital in Sebastopol, Calif., which received a Superior Performance award from the Healthcare Facilities Accreditation Program in May — only the second hospital to do so — and the stroke center of Palo Alto, Calif.-based Stanford Hospital & Clinics, which in November became the first hospital in the country to receive the Disease-Specific Care Comprehensive Stroke Center Certification from The Joint Commission.
However, many hospital stroke programs fail, and the primary reason is they lack a strong stroke coordinator, according to Timothy Shephard, PhD, vice president of Bon Secours Virginia Health System's Neuroscience Institute. "Almost universally, programs that fail or backslide in performance are those [that] lost a stroke coordinator or did not have one and tried to tack it on to someone else's job," he says. "Having seen a few hundred stroke programs, I can unequivocally make this statement."
Stroke coordinator: Lynchpin of stroke team
Stroke coordinators have the responsibility of overseeing all operations of the stroke program, including communicating with all stakeholders, holding monthly meetings and collecting and analyzing data. Due to the scope of the role, hospitals with greater than 100 to 150 ischemic stroke discharges should have a dedicated stroke coordinator. In hospitals with fewer cases, someone could take on the stroke coordinator role as an additional responsibility or cover multiple sites, according to Dr. Shephard.
Stroke coordinators are typically nurses, but stroke coordinators can be anyone with a passion for neuroscience and detailed work. "It's really about sound organization and communication skills — being able to communicate with physicians, being able to educate peers and being able to teach at all different levels," Dr. Shephard says.
Having these skills, however, is not enough. The stroke coordinator should have an interest in and experience with neuroscience. "It's easier to take a person who has a passion for neuroscience and understands neuroscience technically, and train [him or her] to be a coordinator, than take a coordinator and train [him or her] in neuroscience," Dr. Shephard says.
Physician champion: Key ambassador
In addition to a stroke coordinator, stroke teams need a physician champion in order to be successful. Dr. Shephard explains, "It requires a physician champion to work in tandem with the coordinator to help coordinate communication and processes so the program is consistently moving forward." While a stroke coordinator is responsible for communicating with all stakeholders and the stroke team as a whole, the physician champion is responsible for communicating with individuals to ensure everyone buys in to the program. "The physician champion is generally the person who represents the program to their peers [and] communicates with administration on the importance of the program," Dr. Shephard says.
Physician champions can be valuable particularly when the stroke team needs to improve processes to meet quality goals. For example, if a neurologist on the stroke team is consulted and does not respond fast enough, the physician champion would speak with the neurologist about the importance of response time and how the physician can change his or her process to speed that time. Communicating peer-to-peer is often more effective in changing processes than when a stroke coordinator or other clinician speaks with a physician, according to Dr. Shephard.
Strong leaders benefit patients and hospital
Delivering top-quality care to stroke patients is important not only because of the severity of the disease, but also because hospitals are becoming financially accountable for meeting quality measures, including measures related to stroke care. To ensure hospitals meet these goals, they need to have strong stroke program leaders, including a stroke coordinator and a physician champion.
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However, many hospital stroke programs fail, and the primary reason is they lack a strong stroke coordinator, according to Timothy Shephard, PhD, vice president of Bon Secours Virginia Health System's Neuroscience Institute. "Almost universally, programs that fail or backslide in performance are those [that] lost a stroke coordinator or did not have one and tried to tack it on to someone else's job," he says. "Having seen a few hundred stroke programs, I can unequivocally make this statement."
Stroke coordinator: Lynchpin of stroke team
Stroke coordinators have the responsibility of overseeing all operations of the stroke program, including communicating with all stakeholders, holding monthly meetings and collecting and analyzing data. Due to the scope of the role, hospitals with greater than 100 to 150 ischemic stroke discharges should have a dedicated stroke coordinator. In hospitals with fewer cases, someone could take on the stroke coordinator role as an additional responsibility or cover multiple sites, according to Dr. Shephard.
Stroke coordinators are typically nurses, but stroke coordinators can be anyone with a passion for neuroscience and detailed work. "It's really about sound organization and communication skills — being able to communicate with physicians, being able to educate peers and being able to teach at all different levels," Dr. Shephard says.
Having these skills, however, is not enough. The stroke coordinator should have an interest in and experience with neuroscience. "It's easier to take a person who has a passion for neuroscience and understands neuroscience technically, and train [him or her] to be a coordinator, than take a coordinator and train [him or her] in neuroscience," Dr. Shephard says.
Physician champion: Key ambassador
In addition to a stroke coordinator, stroke teams need a physician champion in order to be successful. Dr. Shephard explains, "It requires a physician champion to work in tandem with the coordinator to help coordinate communication and processes so the program is consistently moving forward." While a stroke coordinator is responsible for communicating with all stakeholders and the stroke team as a whole, the physician champion is responsible for communicating with individuals to ensure everyone buys in to the program. "The physician champion is generally the person who represents the program to their peers [and] communicates with administration on the importance of the program," Dr. Shephard says.
Physician champions can be valuable particularly when the stroke team needs to improve processes to meet quality goals. For example, if a neurologist on the stroke team is consulted and does not respond fast enough, the physician champion would speak with the neurologist about the importance of response time and how the physician can change his or her process to speed that time. Communicating peer-to-peer is often more effective in changing processes than when a stroke coordinator or other clinician speaks with a physician, according to Dr. Shephard.
Strong leaders benefit patients and hospital
Delivering top-quality care to stroke patients is important not only because of the severity of the disease, but also because hospitals are becoming financially accountable for meeting quality measures, including measures related to stroke care. To ensure hospitals meet these goals, they need to have strong stroke program leaders, including a stroke coordinator and a physician champion.
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