“There are a lot of requirements, a lot of moving parts that have to come together,” explains Jaime Rocha, stroke coordinator at Paradise Valley Hospital. “But I think we’re in a good position to take that next step.” That next step Jaime mentions is Paradise Valley becoming certified by The Joint Commission (TJC) as an “acute stroke ready” hospital.
There are three levels of stroke care certification with TJC. The highest level is a comprehensive stroke center. These facilities have comprehensive infrastructure and resources for dealing with the most complex stroke-related problems. The two comprehensive centers in San Diego county are UCSD Health and Scripps Memorial La Jolla. The second and third levels are primary stroke center, and acute stroke ready hospitals. PVH is currently designated by San Diego County as a stroke receiving facility, but becoming a TJC certified “acute stroke ready” is our immediate goal.
To reach that goal, the hospital must prove to TJC that we have the ability to have a stroke team at the patient’s bedside within 15 minutes at any time. We have to prove that we can provide CT scans, MRI, the proper lab work in a timely manner, and have a neurologist available to evaluate the patient at any time, either in person or remotely via the telemedicine robot. “The robot is a great tool,” says Jaime. “It’s essentially a large screen with cameras. You wheel it up to the bedside of a patient, and a physician from a remote location can use it to observe and interact with the patient. The doctor can see the patient through the cameras,and the patient can see the doctor’s face on the screen, and they communicate that way. The doctor can even control the angles of the cameras. It’s remarkable!”
There are other strict criteria that the hospital must adhere to achieve this certification. We must prove we can consistently provide neuro-surgical services within a three-hour window; we have to show that we have the ability to provide a stroke victim with Alteplase, a powerful thrombolytic drug administered intravenously to dissolve blood clots; we have to have the ability to transfer patients via ground or air transportation; and we must have a transfer agreement in place with at least one of the comprehensive stroke centers in San Diego County.
“So far, so good,” says Jaime. “All the pieces are in place. Our ED staff, critical care staff, lab, imaging—everyone’s been training and learning how to coordinate their duties to meet the time and educational standards. The TJC evaluation period starts on February 1, and we feel ready.”
(Pictured above: PVH staff work with the crew of a Mercy Air medical transport team on a simulated patient transport. The landing area is a on the campus of neighboring Paradise Manor along 8th Street.)