When car crash victims suffer serious injuries, emergency crews often get them to trauma centers for the advanced care they need. That same concept has come to stroke care, as evidence grows that coordinated, advanced treatment can make a huge difference for patients who suffer a "brain attack."
Recently, the University of Michigan Health System earned the nation's highest designation for stroke care, after a thorough inspection and review by the organization that certifies such programs. Only 70 other hospitals in the country have achieved this elite status.
U-M's Comprehensive Stroke Program now holds the official certification of Comprehensive Stroke Center, granted by the Joint Commission accrediting organization and recognized by the American Heart Association and American Stroke Association.
The team, the team, the team
The new designation means UMHS has highly trained hospital teams and technologies ready at a moment's notice, around the clock, 365 days a year. They have trained and prepared to act together, giving each patient the best options for treatment.
This includes the ability to rapidly diagnose what is causing each patient's stroke symptoms, using advanced medical imaging when necessary. It also includes the ability to deliver time-critical treatments and procedures to dissolve blood clots in the brain, to remove stubborn clots or repair the source of bleeding in the brain.
UMHS even has a unique surgical room where a CT scan of the head can be performed in the same room where doctors can remove clots from vessels or repair brain aneurysms. This improves care and safety, and saves precious time.
The certification also means advanced care beyond the crucial first hours after a stroke strikes -- including inpatient care within University Hospital and the Frankel Cardiovascular Center, individualized rehabilitation and outpatient care once stroke survivors have left the hospital, and top care for patients at high risk of a stroke.
The U-M program, led by stroke neurologist Eric Adelman, M.D., neurosurgeon Aditya S. Pandey, M.D., and emergency medicine physician William Meurer, M.D., involves doctors, nurses, therapists and other staff who work together to give seamless care from the moment a patient arrives in the U-M emergency department either from their home or another hospital.
Because U-M researchers also study stroke, and coordinate national and statewide stroke care improvement studies, patients who come to UMHS for stroke care also receive treatment based on the latest research -- and often have access to clinical trials of new options that few other hospitals offer.
"It takes a strong team to give a stroke patient absolutely optimum care, and that's what we aim to do," says Pandey, an assistant professor in the U-M Medical School's Department of Neurosurgery who specializes in minimally invasive brain procedures for patients having or at high risk of a stroke. "The outcomes our patients achieve and the number of stroke patients we treat are the true indicators of the high-quality stroke care provided at the University of Michigan."
"The spectrum of what we offer, and the way we incorporate the latest knowledge into our clinical care, truly sets us on a level with few other centers in the country," says Adelman, an assistant professor in the U-M Department of Neurology. "But even with everything we can provide here at U-M, it's up to people who suffer strokes, and community members, to recognize the signs of stroke and get help quickly."
Stroke is the leading cause of long-term disability and the fourth leading cause of death within the United States. A stroke occurs every 45 seconds and stroke causes a death every 4 minutes.
The U-M team, and the American Stroke Association, recommend that everyone memorize the "FAST" method for spotting and reacting to the warning signs of stroke:
• Face Drooping -- Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
• Arm Weakness -- Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
• Speech Difficulty -- Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?
• Time to call 9-1-1 -- If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared.
The American Stroke Association and its partner the AHA have recognized UMHS for high-quality stroke care since its program began in 2005, including repeated designation as a Gold Plus stroke hospital every year since 2006.
"By achieving this advanced certification, U-M's Comprehensive Stroke Program has thoroughly demonstrated the greatest level of commitment to the care of its patients with a complex stroke condition," says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president and CEO of The Joint Commission. "Certification is a voluntary process and The Joint Commission commends U-M for successfully undertaking this challenge to elevate the standard of its care for the community it serves."
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