Big f*cking whoopee.
https://muhc.ca/newsroom/article/when-every-second-counts-mgh-and-mnh-become-specialized-stroke-centres
Two McGill University Health Centre (MUHC)
hospitals have recently received new accreditations: the Montreal
General Hospital (MGH) was designated a secondary stroke centre and the
Montreal Neurological Hospital (MNH), a tertiary stroke centre. The
accreditations were granted after a successful reorganization of
services that has optimized speed and quality of care for stroke
patients. So, it was with great pride that around 40 members of the MUHC
Stroke Program and MUHC administrators celebrated the news.
“The
MUHC is the only medical institution in Quebec to have a tertiary and a
secondary stroke centre,” says Neurologist Dr. Robert Côté, medical
director of the MUHC Stroke Program. “Both units are ultra-specialized
and provide rapid assessment, diagnostics and treatment for any type of
stroke intervention. The only difference between them is that the MNH
has interventional neuroradiology (INR), a procedure used to retrieve
clots inside the arteries.”
The transformation of
services is part of a stroke strategy put in place by the Ministry of
Health in 2013 to improve stroke prevention and healthcare services
offered to the more than 12,000 Quebeckers who experience a stroke every
year. For every one of them, time is of essence.
“Time
is brain,” says Dr. Côté. “For every minute a stroke is left untreated,
2 million brain cells are destroyed. So, the sooner we treat patients
the higher the chances of survival with fewer disabilities. That’s
better for patients and their families, of course, but it’s also cost
effective.”
In the last two years, a Stroke
Coordinating Committee, with representatives from the MGH and MNH,
worked diligently to fulfill the ministry’s long list of criteria and
receive the accreditation. One important requirement was that each unit
have a dedicated stroke team.
“That means that the
same professionals will follow a patient from admission until
discharge,” explains Rosa Sourial, clinical nurse specialist in the MUHC
Stroke Program. “Furthermore, a nurse clinician facilitates continuity
of care throughout the hospitalization and collaborates with patients,
families and the stroke team in planning the next phase of recovery
which involves rehabilitation and follow up in the MUHC Stroke
Prevention Clinic.” (Please see : Upgraded Stroke Prevention Clinic improves health services offered by the MUHC)
The
two centres also reviewed and improved their procedures to fulfil three
other requirements: improve access to diagnostic testing, decrease the
length of stay of patients and engage patients and families in the plan
of care. (Maybe results of 60 minute delivery of tPA?)
“Although patient experience hasn’t been
formally tested, a survey carried out by nurse managers in both units
indicated that patients and families feel they are better informed about
stroke care,” says Sourial.
The improvements in
access, continuity and quality of care in both units also benefit
patients who were not initially targeted by the stroke program, such as
those with transient ischemic attacks (TIA). The success in the
transformation is even more meaningful because it was achieved during a
challenging time.
“We underwent the rigorous process
of accreditation in a context of budget constraints and in the middle of
the transition of the Royal Victoria Hospital, which was the entry
point for our stroke patients, to the Glen,” says Dr. Côté.
As Rosa Sourial puts it, the whole process has been “a lot of work, but a fun ride”.
“Our
teams joined forces to improve the health of the population and we can
see the results,” she says. “This is not about us, but about our
patients. I hope the two stroke centres will get even better in the
future.”
Upgraded Stroke Prevention Clinic improves health services offered by the MUHC
The
accreditation work at the two stroke centres had another major positive
result. For the past year, the MUHC Stroke Prevention Clinic (SPC)
located at the Montreal General Hospital (MGH) has been offering
enhanced acute evaluation services to patients with a transient ischemic
attack (TIA).
“A TIA produces similar symptoms to
those of a stroke such as sudden weakness on one side of the body, face
droopiness or difficulties finding words, says Heather Perkins, nurse
clinician in the Stroke Prevention Clinic. “It usually lasts only a few
minutes and often causes no permanent damage, but should be taken
seriously, because these patients are at higher risk of having a
stroke.”
The clinic accepts referrals from emergency
departments and general practitioners in the community. It has the
same access to radiology and ultrasound equipment as the Emergency
Department so that all exams can be done as soon as is needed. It also
follows up on patients recovering from a stroke and quickly refers them
to rehab specialists.
Along with the new services, the
clinic pursues its main vocation: to educate healthcare workers and
patients about TIAs and strokes. As Neurologist and Medical Director of
the MUHC Stroke Program Dr. Robert Côté explains, “The Stroke Prevention
Clinic is extremely important. We can treat patients for acute stroke
and send them to rehabilitation, but we don’t want them to come back
with another stroke.”
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