Auburn Memorial receives New York State Designation as a Stroke Center
Posted on: 08/29/2011
Partnership with University of Rochester Medical Center Neurosciences Program Enhances Care
Auburn Memorial Hospital President/CEO, Scott A. Berlucchi today announced that the New York State Department of Health has designated Auburn Memorial Hospital as a Stroke Center. This designation recognizes its excellent emergency services and in-patient capabilities in stroke evaluation, diagnosis, continuing treatment, and rehabilitation.
The designation also recognizes Auburn Memorial Hospital’s efforts in staff development and community awareness.
“The New York State Department of Health has established a set of evidence-based clinical standards in stroke care and offers the Stroke Center designation only when all of these standards are put into action,” Berlucchi said. “The true beneficiaries of this designation are the many patients we serve and their families who will seek treatment here knowing they will receive the highest standard of care.”
Collaborating for Excellence
For nearly two years, Auburn Memorial Hospital has worked with the University of Rochester Medical Center to develop a Stroke Center. URMC provides 24-hour emergency stroke consultative service for patients in the Auburn region. The partnership enables physicians in Auburn to consult with neurologists and neurosurgeons at URMC’s Strong Stroke Center via a web based system.
“While stroke is the nation’s leading cause of disability, we know that timely emergency care can determine an individual’s chances of recovery,” said Curtis Benesch, M.D., director of the Strong Stroke Center. “This partnership improves access to stroke specialists for physicians and patients in Auburn which is a critical step toward improving outcome for stroke patients.”
“Collaborating with URMC brings modern medical research and technology to our community and illustrates our commitment to providing the highest level of quality care to our community hospital,” Berlucchi said. “Advances in technology allowed us to bridge the geographic gap between URMC and Auburn, and in doing so allows our Emergency Department doctors access to one of the nation’s best neurosciences programs in the country.”
Physicians in Rochester and Auburn will employ a technology called Image Transfer. This web-based system allows physicians to remotely review computed tomography (CT) images and MRI of the patient’s brain to support AMH physicians in determining the most appropriate course of treatment for the patient.
The primary goal of this initiative is to overcome the geographic disadvantage in treating patients with acute ischemic stroke – a type of stroke caused when an artery in the brain becomes obstructed, cuts off the flow of blood, and, if not treated quickly, causes brain cells to die, often resulting in permanent neurological damage.
One of the key decisions in the care of individuals with ischemic stroke is whether or not to give patients a clot busting drug called tissue plasminogen activator (tPA). In order to be effective, tPA must be administered within 3 hours of the onset of the symptoms of stroke. This period of time is called the tPA “window” and once it has past, physicians are reluctant to administer the drug because it may cause dangerous bleeding in the brain.
In the absence of trained stroke specialists, it falls upon physicians in the emergency department to determine the course of treatment. Not all strokes are the same and the decision whether or not give the patient tPA is based on a complicated number of factors, which can contribute to a reluctance to use the drug without the consultation of a neurologist or a neurosurgeon. Consequently, the drug is only administered in a small fraction of strokes; of the more than 700,000 cases every year nationally, only an estimated 2-4% receive tPA.
For patients who are ineligible for tPA, recent advances in intra-arterial intervention – a procedure in which surgeons physically remove the clot from the vein – may be another option. Patients who require advanced procedures not available at Auburn can be transferred to Rochester.
“Access to physicians who are trained to identify acute ischemic stroke, evaluate risk factors, and help physicians on the ground decide upon a course of treatment will increase the number of people who receive the appropriate care,” said URMC neurosurgeon and neurointerventionalist Babak Jahromi, M.D., Ph.D. “When faced with a brain attack time is brain. We must ensure our emergency department physicians have all the tools to rapidly triage patients who are within the window for intravenous tPA or who may require advanced therapies such as intra-arterial intervention for stroke.”
Stroke Center Designation
The New York State Department of Health requires that hospitals meet several requirements in order to be designated a stroke center. These requirements include having 24-hour access to a team of physicians with specialty training in stroke care. In addition, Auburn Memorial Hospital has committed to an ongoing program to continually meet the 31 New York State Department criteria, which include the hospital’s demonstrated ability to:
· Establish communication protocols with area EMS services.
- Activate a stroke team so it is at a patient’s bedside within 15 minutes.
- Follow strict protocols for the treatment of acute stroke, including the use of treatments such as tPa (a powerful yet tricky clot-breaking drug) and/or the transfer of patients who need intra-arterial therapy known as MERCI.
- Employ a medical director with advanced training and commitment to continuing education
- Ensure the 24/7coverage
- Adhere to a 45-minute window from patient arrival to conduct and evaluate a CT scan and laboratory results and to begin treatment.
- Establish and staff a dedicated in-patient unit for continued stroke care.
Warning Signs of Stroke
With acknowledgement to the American Stroke Association, we remind everyone of the warning signs of stroke:
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
Not all of these warning signs occur in every stroke. If some occur, don’t wait. Get help immediately. Stroke is a medical emergency. Call 911.
For more information, go to timeisbrainatauburn.com, a new website dedicated to providing educational information about the warning signs of a stroke, what to do if a loved one has a stroke and a variety of other handy tips for Auburn area residents. Promotional efforts for the stroke initiative are made possible through a collaborative between URMC, Auburn Memorial Hospital and the Fred L. Emerson Foundation.
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