Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, July 28, 2021

Organization and implementation of a stroke center in Panamá

Notice they start from the wrong objective; 'care'. Copying the failed policies of first world stroke units doesn't solve the problem of getting survivors 100% recovered.

Organization and implementation of a stroke center in Panamá

20 Apr 2021 | International Journal of Stroke

In order to coordinate the best possible treatment options for stroke patients a highly organised and streamlined pathway is needed, covering all aspects of stoke care, from initial screening to treatment. Stroke Units are one of the most efficient ways to do this.

In order to coordinate the best possible treatment options for stroke patients a highly organised and streamlined pathway is needed, covering all aspects of stoke care, from initial screening to treatment. Stroke Units are one of the most efficient ways to do this.

Stroke Units are central to stroke care in most high-income countries, but many low- , middle- and emerging-high income countries do not have organised clinical stroke care pathways. In addition, despite there being many guidelines and protocols available for stroke care many of these have been developed in high-income countries and successful implementation of  stroke care pathways in low- , middle- and emerging-high income countries can be challenging.

“While the guidelines are readily available, key barriers to the successful execution of stroke units in emerging high-, middle- and low- income can be: a lack of organised care systems, and a lack of resources and experience.” explains Dr. Urrutia, of The Johns Hopkins Hospital’s Comprehensive Stroke Center.

To overcome some of these barriers, the team at Pacífica Salud in Panamá led by Dr. Novarro-Escudero, came together to design and implement a Stroke Centre for its hospital in collaboration with, and under the mentorship of, The Johns Hopkins Hospital, Baltimore, USA.

In 2016 the process of developing a stroke program began. The collaboration saw the teams adapting guidelines for translating evidence into practice by Pronovost et al1 into 7 steps, which were then used to execute their programme. These were:

  1. Assessment of best practice and guidelines.
  2. Survey to establish current stroke care, resources and staff.
  3. Multidisciplinary stroke task force established across all departments involved in stroke care, to establish policies and procedures.
  4. Education programmes for all staff.
  5. Variables measuring quality of stroke programme established.
  6. Policies and procedures implemented and stroke programme formally launched.
  7. Continuation of multidisciplinary stroke task force. Progress and Quality Improvement was monitored.

“Since the development and implementation of the stroke programme at Pacífica Salud, year over year comparisons have shown an increase in the number of stroke patients treated and the number of acute interventions carried out.” said Dr. Urrutia.

The teams have attributed their success to the excellent collaborative efforts and believe the mentorship programme positively enhanced their accomplishments. “We believe this mentorship model is the way forward” explained Dr. Urrutia “we were able to overcome difficulties with translating evidence into practice through experience, teaching and education”.

 

 

References

  1. Pronovost PJ, Berenholtz SM, Needham DM. Translating evidence into practice: A 347 model for large scale knowledge translation. BMJ. 2008;337:a1714
 

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