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Published: Tuesday, 3/22/2005

MCO attains stroke center designation

BY LUKE SHOCKMAN
BLADE STAFF WRITER

The Medical College of Ohio has been named a "primary stroke center" by the organization that accredits the nation's hospitals, one of just eight Ohio hospitals to achieve the designation and the only one in northwest Ohio.

Stroke experts nationwide are pushing hospitals to adopt improved stroke care standards, including pursuing certification as a stroke treatment center. Each year 700,000 Americans have a stroke and 168,000 die, making it the leading cause of long-term disability and the nation's third-leading cause of

death. A stroke occurs when a blood vessel in the brain either becomes blocked or bursts.

The thinking is if hospitals adopted standards, which include more widespread use of clot-busting drugs, stroke-related complications and deaths would decline.

"We think this designation is important for patient care," said Dr. Gretchen Tietjen, an MCO neurologist and director of MCO's stroke center. "It does look like centers that are certified give more acute stroke care in their ER, use [clot-busing drugs] more, and they're more ready. The other thing they have shown was it looked like there were better outcomes."

Though MCO is the only area hospital certified as a primary stroke center now, it soon may have company. Toledo Hospital is seeking certification, and St. Vincent Mercy Medical Center is looking into it, according to spokesmen at both hospitals.

The Joint Commission on the Accreditation of Healthcare Organizations [JCAHO], working with the American Heart Association and the American Stroke Association, is responsible for certifying stroke centers. JCAHO is best known in the hospital industry as the organization that surveys a hospital to evaluate whether the entire facility is meeting certain overall standards.

The designating of stroke centers is a new program for the commission, but it has "really taken off," according to M.J. Hampel, a commission official involved in the certification process.

"The whole idea of certifying centers is so consumers know where they can go to get the most expedited care for treatment," she said.

Ms. Hampel said some hospitals are aggressively marketing their certification and using their new designation to remind EMS crews transporting stroke patients that their facility has met approved quality care standards. Dr. Tietjen said she hopes MCO's stroke certification gets the attention of area EMS crews as well as patients because patients can decide which facility they want to go to.

Certified centers must adopt and prove they're using standards developed by the Brain Attack Coalition, a group established by professional and government organizations to draw up guidelines on improving stroke treatment. Those guidelines include having a dedicated stroke team available at the hospital all day, every day; developing written stroke-care guidelines; having a neurologist on staff at all times; and ensuring that proper diagnostic tests are quickly performed. In addition, the guidelines call for the use of the clot-busting drug tPA when appropriate.

Some physicians have expressed skepticism of the value of the certification program, especially the call for broader use of tPA. The American Academy of Emergency Physicians, a professional organization representing emergency-room physicians, has refused to endorse tPA use, citing insufficient proof of its safety and effectiveness.

Contact Luke Shockman at:

lshockman@theblade.com

or 419-724-6084.



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