MDNews - Greater Kansas

April/May 2018

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James Walker, MD Medical Director, Via Christi Neuro-Critical Care Unit FOR VIA CHRISTI Hospita l St. Francis to earn certification as a Comprehensive Stroke Center by The Joint Commission, it had to demonstrate that it had the specia lized stroke care team and protocols in place 24 hours a day, seven days a week, to care for even the most complex cases. Designation as the regiona l leader for advanced stroke care a lso required a demonstrated commitment to continuous improvement in patient outcomes, which were a lready better than the nationa l average. The team did so in 2016 and recently underwent a recertifica- tion survey for which the results are pending. Today, St. Francis is one of only two Kansas hospita ls to achieve cer tif ication a s a Comprehensive Stroke Center, which typica lly is the largest and best-equipped hospita l for treating any kind of stroke, stroke complication or other neuro- endovascular disease within a particular geographica l area. It's also home to the region's only dedicated neurocritical care unit — a 20-bed unit staed by specially trained neuroscience nurse practitioners, physician assistants and bedside nurses and equipped with the advanced neuro-imaging and neurosur- gery capabilities needed to treat ischemic strokes, hemorrhagic strokes, aneurysms and other neuro-endovascular conditions. In 2017, it s tea m t reated 8 4 0 st roke patient s, i nclud- ing 630 with ischemic strokes a nd 210 with hemorrhag ic strokes, and received stroke transfers from more than 60 Kansas hospitals. In 2017, the average door-to-needle time at Via Christi was 43 minutes. Its faster door-to-treatment times, which lead to better patient outcomes, have come a s a result of eor ts to help prehospital sta and sta from transferring facilities recognize complex stroke situations so that they can let the Via Christi team know that an acute stroke care patient is in route. To further reduce treatment times, Via Christi and Butler County EMS are piloting a process that connects the fa mily or bysta nder who obser ved the stroke with the team at Via Christi so that a medical history can be obtained prior to the patient's arriva l. I n Ja nu a r y 2 017 — ba s e d on V i a Christi's performance and designation as a Comprehensive Stroke Center — the Medica l Societ y of Sedg wick Count y endorsed rout i n g t he most complex st roke pat ient s t o St . Fra nci s. T h i s prehospital notification, together with a direct-to-CT scanner protocol, is help- ing triage patients through the system much quicker, resulting in improved door-to-puncture endovascular treat- ment times. This will be increasingly i mp or t a nt a s t he A mer ic a n Hea r t A s s o ci at ion a nd A mer ic a n S t r oke Association's 2018 guidelines recommend extending the window for endovascular treatment from six hours to 24. "Our goal is to work with other Kansas hospitals to build better systems of care by creating a statewide hospital network equipped to recognize, treat and transfer patients with stroke symptoms to a higher level of care in a timely manner," says Kristina Willour, RN, Via Christi's Stroke Program Coordinator. St. Francis was the area's first accredited stroke center. "And thanks to the exceptiona l team we've established," says Sher r y Hausma n n , Via Ch r ist i R eg iona l Hospit a l President, "we continue to serve as the regional leader in stroke care 14 years later." ■ Kumar Reddy, MD Medical Director, Via Christi Neurovascular and Interventional Radiology BEST OF THE BEST Comprehensive STROKE CARE That's Among the M D N E W S . C O M /// M D N E W S G R E AT E R K A N S A S ■ 2 018 S T R O K E C A R E ❰❰❰❰❰ 3 5

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