Allegheny Valley Hospital earns advanced certification for stroke care - Natrona Heights, PA

Big fucking whoopee.

You can check out Joint Commission standards here:

 http://www.jointcommission.org/assets

 I saw absolutely nothing about what should be done the first week or anything about measuring 30-day deaths and 100% recovery. A higher standard of service is not good enough, Survivors want results, 100% recovery.

 

Measurements, guidelines, standards and care mean nothing to stroke patients, get your fucking heads out of your asses and start measuring results. Then you can start crowing. 
If you are going to crow about something tell us how many of your stroke patients you will get to 100% recovery. THAT IS THE ONLY CRITERIA.

 

Allegheny Valley Hospital earns advanced certification for stroke care - Natrona Heights, PA

Brian C. Rittmeyer | Friday, April 12, 2019 1:39 p.m.

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Allegheny Valley Hospital has been recognized for its care of stroke patients.
The Harrison hospital earned an advanced certification for primary stroke centers from The Joint Commission, the hospital announced Friday.
This is the first time the hospital has received the certification, Allegheny Health Network spokeswoman Stephanie Waite said.
Founded in 1951, the nonprofit commission accredits and certifies more than 21,000 health care organizations and programs in the U.S.
The hospital earned the commission’s “Gold Seal of Approval” and a “Heart-Check” mark from the American Heart Association and the American Stroke Association.
Joint Commission experts conducted an on-site review of the hospital using standards developed with the heart and stroke associations to evaluate compliance with stroke-related care standards and requirements.
“We commend Allegheny Valley Hospital for becoming a leader in stroke care, potentially providing a higher standard of service for stroke patients in the community,” said Patrick Phelan, executive director of hospital business development for The Joint Commission.
The hospital is the only certified primary stroke center in the Alle-Kiski Valley, interim President and CEO Jeffrey Carlson said.
“When someone suffers a stroke, time to treatment is of the utmost importance in giving that person the best chance at a full recovery,” he said. “Residents of the region can be assured that our skilled caregivers are providing a high level of stroke care, as confirmed by these prestigious national organizations.”
Stroke is the fourth-leading cause of death and a leading cause of adult disability, affecting nearly 800,000 people each year. Symptoms include a drooping face and arm weakness, particularly on one side of the body, along with slurred speech and difficulty seeing.
People with high blood pressure and cholesterol levels and those who smoke or are obese are at risk; African-Americans and people over 60 are also at higher risk.
Started in 2003, the advanced certification is awarded for two years to Joint Commission-accredited acute care hospitals.
“We are grateful for this national recognition as it reflects our success in offering patients who suffer from this common and often disabling cerebrovascular injury the highest quality of care at AVH and through Allegheny Health Network,” said Dr. Ashis Tayal, medical director of the Comprehensive Stroke Center at Allegheny General Hospital and director of the network’s Cerebrovascular Center.

Brian C. Rittmeyer is a Tribune-Review staff writer. You can contact Brian at 724-226-4701, brittmeyer@tribweb.com or via Twitter .

HFAP-Certified Stroke Centers Met or Exceeded Industry Standards, Per Report

Well then those fucking standards are wrong. They don't refer to recovery results, just processes completed. These people all need to be keel hauled and removed from the stroke medical world. We need stroke leadership, NOT this lazy crapola. If you were my employee and came to me with this as your performance goal results I would have you fired.
http://www.ptproductsonline.com/2018/07/hfap-certified-stroke-centers-met-exceeded-industry-standards-per-report/

According to a recently released benchmarking report, Healthcare Facilities Accreditation Program (HFAP)-certified primary stroke centers met or exceeded benchmarks identified for the majority of performance measures set by the American Heart Association.

Reportedly the first of its kind, the external benchmarking resource identifies target goals and compares results achieved by individual centers.

“We designed the benchmarking report as a tool for both certified and non-certified stroke centers to use for education and training to ensure their programs are meeting specific thresholds,” says Marci Ramahi, director, accreditation and certification operations, per a media release from HFAP.

“Stroke coordinators at certified centers can also share the information in this report within their organizations to demonstrate the quality of their stroke care program or areas for improvement to key stakeholders.”

The HFAP benchmarking report analyzed data from July to December 2017 to determine whether benchmarks identified for each performance measure were achieved. The data represent patients 18 years and older who arrived in the emergency department or who experienced onset of symptoms while in the hospital for another diagnosis.

On average, participating stroke centers surpassed industry standards in key areas including:(None of these are recovery results, 100% recovery is the only goal. GET THERE!)

• Stroke Team Arrival: Stroke teams responded to 96% of patients’ bedside within 15 minutes of arrival in ED or, for inpatients, of onset of symptoms. Benchmark at 85%.
• Thrombolytic Therapy: Stroke teams initiated IV tPA to 96% of acute ischemic stroke patients within three hours of time last known well. Benchmark at 85%.
• Antithrombotic Therapy: Stroke teams administered the first dose of antithrombotic therapy by the end of hospital day two to 97% of all eligible ischemic stroke patients. Benchmark at 85%.
• Anticoagulation Therapy for AF/Flutter: Stroke teams provided prescriptions for anticoagulants at the time of discharge to 99% of eligible ischemic stroke patients. Benchmark at 85%.
• Stroke Education: Stroke teams equipped 96% of ischemic or hemorrhagic stroke patients or their caregivers with educational materials on stroke care during their stay. Benchmark at 85%.
• Assessed for Rehabilitation: Stroke teams conducted a physical rehabilitation evaluation for 98% of eligible patients. Benchmark at 85%.

“The data used to generate the benchmarking report are key clinical performance metrics primary stroke programs must track and submit quarterly to be certified,” Ramahi says.

“In addition, centers use these measures for internal benchmarking of their care and processes. We compiled this report to help our stroke center partners and other stroke programs develop data-driven quality improvement initiatives and improve clinical outcomes.”

For more information, visit HFAP.

[Source: HFAP]

Medicaid Plan Networks Must Meet Standards: CMS

Somehow stroke survivors will need to be some of the voices in setting standards for stroke care. We can't let doctors do this because they will just propose guidelines, not RESULTS. That would be ensuring stroke rehab failures for decades.
http://www.medpagetoday.com/PublicHealthPolicy/Medicaid/57533?

• by Joyce Frieden
  News Editor, MedPage Today

WASHINGTON -- States will need to establish network adequacy standards for Medicaid managed care providers under a final rule issued Monday by the Centers for Medicare and Medicaid Services (CMS).
"Today's final rule has four goals: supporting states' efforts to advance delivery system reform; strengthening the consumer experience of care; strengthening program integrity; and aligning rules across health insurance coverage programs to improve efficiency and help consumers," said Vikki Wachino, MPP, director for the Center for Medicaid and CHIP Services at CMS, on a conference call. As part of those goals, "Our final rule requires states to establish network adequacy standards, and to establish time and distance standards for primary care physicians, behavioral health providers, pharmacy providers, and pediatric dentists."
The rule also requires network adequacy standards for specialists, but leaves it up to states to decide which specialists and what the standards will be. "We agree with commenters that states should define this category and set network adequacy standards that are appropriate at the state level," the final rule stated.
"We believe that allowing states to define the 'specialist' category better reflects the needs of their respective programs, and we believe it would be inappropriate for CMS to define this standard at the federal level. We also believe that states are in the best position to engage a variety of stakeholders when defining the 'specialist' category and setting appropriate network adequacy standards for such defined 'specialist' providers. We specifically encourage states to be transparent in this process."
States must comply with the network adequacy requirements "no later than the rating period for Medicaid managed care contracts starting on or after July 1, 2018," according to the rule.
The 1,424-page rule also establishes the program's first-ever quality rating system, and "requires additional transparency on how Medicaid rates are set to help ensure fiscal integrity of the Medicaid managed care program, including data on utilization and quality of services," Wachino said.
In addition, it "sets medical loss ratios for Medicaid managed care plans and better aligns reporting of medical loss ratios with Medicare Advantage and the marketplace. This will improve the experience for people who transition between coverage programs, and eases the burden on providers who participate in several programs."

A comparison of stroke rehabilitation; data from two national cohorts

More proof that worldwide everything in stroke is fucked up. No standards for anything. You're screwed as a stroke survivor wherever you live.
http://onlinelibrary.wiley.com/doi/10.1111/ane.12542/abstract;jsessionid=F1FABB4706C160DE11D0DA4F08375696.f02t02?userIsAuthenticated=false&deniedAccessCustomisedMessage=

1. G. Bērziņa^1,*,
2. A. Vētra¹ and
3. K.S. Sunnerhagen²

Article first published online: 15 DEC 2015

DOI: 10.1111/ane.12542

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

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Acta Neurologica Scandinavica

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Keywords:

• activities of daily living;
• stroke;
• complex interventions;
• length of stay;
• rehabilitation;
• shift analysis

Objectives

Inpatient rehabilitation is a commonly used complex intervention to improve a person's independence after stroke. Evaluation and comparison of the effects of routine clinical practice could provide a contribution towards optimization of stroke care. The aim of this study is to describe results of inpatient rehabilitation as a complex intervention for persons after stroke and explore possible differences between two countries.

Methods

Data from 1055 Latvian and 1748 Swedish adult patients after stroke receiving inpatient rehabilitation, during 2011–2013, were used for this retrospective cohort study. Qualitative description of systems, as well as information on basic medical and sociodemographic information, and organizational aspects were reported. Change in the Functional Independence Measure during rehabilitation was investigated. In six domains of the instrument, the shifts for three levels of dependence were analysed using ordinal regression analysis.

Results

The components of stroke care seem to be similar in Latvia and Sweden. However, the median time since stroke onset until the start of rehabilitation was 13 weeks in Latvia and 2 weeks in Sweden. The median length of rehabilitation was 12 and 49 days, respectively. The level of dependency at start, time since stroke onset and length of the period had an impact on the results of the rehabilitation.

Conclusions

Although components of the rehabilitation are reported as being the same, characteristics and the outcome of the inpatient rehabilitation are different. Therefore, comparison of stroke rehabilitation between countries requires caution.

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Acute stroke: treatment standards should be further improved

This is from Germany, but any objective look at stroke results anywhere in the world would consider them to be a complete failure. Yet there is always this happy talk about prevention and getting to the hospital fast so you can get tPA. Both of which have to be considered complete failures.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=147865&CultureCode=en
Stroke is one of the most common disorders in Germany, with more than 250,000 cases every year. The consequences for those affected are dramatic: fewer than six in every 10 patients leave the hospital with a positive prognosis after a stroke. The others will have disabilities three months post-stroke or will have died. High-quality acute treatment is therefore crucially important. In the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2014; 111: 759–65), the German Stroke Registers Study Group (ADSR) documents the quality of treatment of patients with acute stroke on the basis of case data from participating hospitals. The current study reported by Silke Wiedmann and colleagues shows to what extent the ADSR’s quality indicators were put into practice in 2012.
To this end, they investigated the disease course of more than 260,000 patients from 627 hospitals nationwide, which represents an estimated 70% of all stroke cases in Germany. The study shows that in many areas, stroke patients received very good treatment, and that in the international comparison, a similar or even better quality is achieved in Germany. In some areas, the targeted treatment quality is not fully realized—for example, in the administration of anticoagulants in atrial fibrillation, screening for dysphagia, or the provision of information to patients or their relatives. The authors therefore recommend implementing consistent standards throughout Germany.

Stroke rehabilitation services in New Zealand: a survey of service configuration, capacity and guideline adherence

You will need to contact your doctor and get the actual standards to see if they are useful at all. Only results should be used as a way to rate the stroke units, not processes.
1.  tPA full recovery percent,
2.  30 day death rates,
3.  accurate diagnosis of stroke events,
4.  100% recovery.
https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2014/vol-127-no-1402-12-september-2014/6288
Summary We surveyed all New Zealand stroke rehabilitation units in late 2013 and asked
them to describe the set-up of the unit and whether they met NZ Stroke Guideline standards
for stroke rehabilitation. Overall, improvements were noted from the last survey in 2007.

Stroke care at Galloway Community Hospital outperforming national standards - Scotland

This is actually f*cking appalling that the national standards are that low that meaningless stuff is measured. You want to measure;
1.  tPA full recovery percent,
2.  30 day death rates,
3.  accurate diagnosis of stroke events,
4.  100% recovery.
None of this namby-pamby crap.
And unless YOU call them on the carpet, they will continue down this failed path.
http://www.gallowaygazette.co.uk/news/local-headlines/stroke-care-at-galloway-community-hospital-outperforming-national-standards-1-3538991
The Stranraer hospital has admitted 100 per cent of patients with a stroke to a stroke unit within one day of admission. (SO WHAT?)
These excellent statistics have recently been published by the Stroke Association. The GCH also ranks 12th out of 32 hospitals in meeting stroke care performance standards.
A spokesperson for the organisation said: “This is very good given the positive outcomes that being in a stroke unit can bring. The hospital has also done well with the other standards apart from the time to treat eligible patients with aspirin which is sitting at 79 per cent versus 100 per cent. It is hoped there will be continuous improvement in meeting or outperforming the standards in the future.
“The Scottish Stroke Care Audit Report looks at the quality of stroke care against a set of standards. These standards are mainly around getting diagnosed and treated in the right place, by the right people and at the right time. (Notice that they don't talk about results)

More at link.

Sutter Rehabilitation Institute Accreditation for Stroke and Brain Injury Care - Roseville, Calif

I couldn't find any stroke standards at the CARF website - http://www.carf.org/home/
so with nothing public, this is completely f*cking worthless.
Big f*cking whoopee.
http://www.rocklintoday.com/news/templates/community_news.asp?articleid=12950&zoneid=4

HealthSouth Nittany Valley Receives Re-certification by Joint Commission - PLEASANT GAP

Big f*cking whoopee. The standards say nothing about 30-day deaths or 100% recovery so as such are useless for survivors.
http://www.gantdaily.com/2014/04/25/healthsouth-receives-re-certification-by-joint-commission/

Excellence would be reducing 30-day deaths every month and increasing the number getting to 100% recovery. No one gives a shit about procedures, You measure results. Hasn't anyone taken any Business 101 courses?

You can download those standards here:
http://www.jointcommission.org/facts_about_primary_stroke_center_certification/

Stanford Hospital & Clinics Awarded First Comprehensive Stroke Center Certification in the Nation

I know I should be glad they achieved this but the performance measures to meet them are hidden. They should really be publishing the % recovery rates, full and partial. That would be useful to know rather than they have processes in place that may or may not be effective.
http://stanfordhospital.org/newsEvents/newsReleases/2012/stroke-center-certification.html
The Joint Commission and the American Heart Association/American Stroke Association together announced that The Stanford Stroke Center at Stanford Hospital & Clinics in Palo Alto, California, is the first hospital in the country to meet The Joint Commission’s standards for Disease-Specific Care Comprehensive Stroke Center Certification. Comprehensive Stroke Certification is the third Disease-Specific Care program on which The Joint Commission and the American Heart Association/American Stroke Association are collaborating. The other programs include Primary Stroke Center Certification and Advanced Certification in Heart Failure.

The new level of certification recognizes hospitals that have state-of-the-art equipment, infrastructure, staff and training to diagnose and treat patients with the most complex strokes. Comprehensive Stroke Center Certification was derived from the Brain Attack Coalition’s “Recommendations for Comprehensive Stroke Centers,” (Stroke, 2005), and“Metrics for Measuring Quality of Care in Comprehensive Stroke Centers,” (Stroke, 2011),and on recommendations from a multidisciplinary advisory panel of experts in complex stroke care.

A team of Joint Commission expert surveyors evaluated The Stanford Stroke Center on October 18 and 19, 2012, for compliance with the Comprehensive Stroke Center standards and requirements, including advanced imaging and treatment capabilities, 24/7 availability of specialized treatments, participation in research, and staff and physicians with the unique education and competencies to care for complex stroke patients. The surveyors found the hospital met or exceeded all required standards.

“The Joint Commission commends Stanford Hospital & Clinics for seeking and achieving certification as part of its commitment to focusing on the care processes that produce the best outcomes for complex stroke patients,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “Stroke patients who are treated at Stanford can have added confidence that the hospital has put in place the critical elements necessary to meet their unique needs.”

Nothing in here  talks about recovery