Nationally Recognized Stroke Program

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Published on March 21, 2018

Stroke Response Relies on Protocol, Training and Expertise

Stroke Care

"When a stroke activation goes off, I'm immediately thinking time is brain. I'm trying to produce a system that offers the patient every option we can."

~ Christopher Fore, MD

The key to treating stroke patients is to quickly determine if they are having a stroke and quickly deliver the proper treatment — all within one hour of arriving at the Hospital for certain patients. At Concord Hospital, the key to developing a nationally recognized Stroke Program was establishing standard processes for swift assessment and treatment, then strengthening the system through team building, training, collaborations and community outreach.

The goal for administering clot-busting medication to eligible patients is less than 60 minutes — a difficult goal that relies on a complex evaluation and rapid decisions by a highly-trained medical team, said Dr. Christopher Fore, Concord Hospital Stroke Program Medical Director.

“The foundation of being successful is standardizing the process,” he said, so it can be reproduced for each stroke patient. “A reduction in variation is the key to success in a high-stakes situation like acute stroke.”

When Dr. Fore came to Concord Hospital almost 20 years ago, he recognized the stroke response was good, but varied a great deal. He got involved in leading change for stroke treatment as he advocated for a standard stroke activation process aimed at allowing the Stroke Team to decide whether a patient is having a stroke and is a candidate for clot-busting medication and to safely administer this drug, if applicable, in less than 60 minutes. The process also now includes the consideration of other treatments and procedures that may require transfer to another facility.

‘Time is brain’ with stroke treatment — which means the longer it takes to deliver appropriate treatment, the more likely a stroke patient will suffer brain damage. The urgency underscores the importance of having excellent stroke assessment and treatment, close to home.

A key element of Concord Hospital’s stroke response is our collaboration with Massachusetts General Hospital in which fellowship-trained vascular neurologists are available around the clock by video and audio links as part of Concord Hospital’s Stroke Team.

In addition, team building and training in the Forrest D. McKerley Simulation & Education Center have strengthened Concord Hospital’s stroke response. Team practice and training allow us to test and troubleshoot clinical processes without compromising actual patient care.

Our stroke treatment process has improved care and has caught the attention of officials who evaluate hospitals around the country.

“We were told by our DNV accreditation surveyor this year that our stroke activation criteria were so good, that we should publish them,” Dr. Fore said. “Our stroke program manager, Christina Swanberry, RN, has done a phenomenal job dialing-in on the critical elements and creating opportunities to save time in the process.”