October 8, 2015

Vanderbilt Stroke Center lauded by Joint Commission

The Joint Commission has recertified the Vanderbilt Stroke Center for providing complex cerebrovascular care.

The Joint Commission has recertified the Vanderbilt Stroke Center for providing complex cerebrovascular care.

Vanderbilt University Medical Center is one of 96 hospitals in the nation meeting the standards of an Advanced Comprehensive Stroke Center, the highest certification level for a stroke center.

Requirements include having a dedicated neurointensive care unit, the use of advanced imaging capabilities, meeting measured performance guidelines, coordinating care when patients leave the hospital and participating in stroke research.

“The center is set up to provide very rapid emergency treatment of strokes so that we get a patient in time to give them intravenous tPA (tissue plasminogen activator) within the time window,” said Howard Kirshner, M.D., director of Vanderbilt Stroke Center.

In many cases, the patient may be at another hospital where emergency room physicians are coordinating with the Vanderbilt team through teleneurology.

“We can actually look at the patient in their setting and talk through giving IV tPA so that we don’t have to delay to transfer them here before we start treatment,” Kirshner said. “Then if they are good candidates, we can bring them here for interventional treatment. If they do not need any further care, we can leave them at their community hospital.”

In cases where patients require interventional surgery, they are brought to Vanderbilt neurosurgeons.

“Every minute during an acute stroke the brain is losing almost 2 million neurons,” said Michael Froehler, M.D., Ph.D., a neuro internventionalist and director of the Cerebrovascular Service.

“That relates to the loss of functional outcomes down the road, meaning the longer the vessel remains occluded — or the longer the artery remains blocked — the less likely it is to have a good outcome.”

Teamwork is a critical element to providing care in a timely fashion and following through afterward, said Kiersten Espaillat, DNP, the stroke coordinator.

“It’s a wraparound care system,” Espaillat said. “That’s part of the Joint Commission certification — making sure we have that wraparound care for these patients. That we are not just treating them in the now, but we’re also treating them in the future.”