First, you have to know how bad your department is. Nothing here would require the stroke head to be a doctor.
Statistics will be kept on everything, 30 day deaths, 5 day deaths, tPA efficacy, time of tPA delivery., Correct and incorrect diagnosis in the ER of stroke vs. bad balance vs. bleeder and clot based.
This will all be compared to other hospitals and a strategic plan will be created for making each goal a perfect response(100% recovery, no 30day deaths, etc.) You may not know how to initially reach the goals but there will be no slacking off in my hospital. I expect an innovative idea from every person in the dept. on a monthly basis. This person will know every single stroke hospital and dept. head in the US. All local researchers will have office facilities and help with grants/equipment.
Actual size of each stroke dead area and penumbra area will be measured.
Stroke protocols will be created for each deficit AND each dead and damaged area.
An intern will be assigned to compile new stroke research on a daily basis. That will be required reading and translation by all neurologists, PMR doctors, ER doctors and therapists into stroke protocols within a week.
All stroke deaths will be autopsied and dead and damaged areas compared to the initial measurements. Stroke will not be allowed as cause of death. Specific damage will be written up as to why that damage caused the death.
There will be no negativity around the patients - nocebo effect.
Man, am I arrogant. But what is YOUR hospital doing to improve stroke rehab and recovery? ANYTHING AT ALL? Ask for a public acknowledgement of the problems and the goals. Get With the Guidelines and Joint Commission certification are not anywhere close enough to improve stroke results. We can't wait that long. Many people will die unless YOU the public takes charge.
Let the flame wars begin, I look forward to medical apologists and their reasons for not being able to accomplish this.
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