Regional implementation of the stroke systems of care model: recommendations of the northeast cerebrovascular consortium.

BACKGROUND AND PURPOSE

The Northeast Cerebrovascular Consortium was established to examine regional disparities and recommend strategies to improve stroke care based on the Stroke Systems of Care Model.

METHODS

An annual summit was first held in 2006, bringing together public health officials, researchers, physicians, nurses, health professionals, state legislators, and advocacy organizations. Best practices and evidence-based interventions within each of the Stroke Systems of Care Model components were presented. Six writing groups were tasked with cataloging each state's current activities and identifying goals for the region.

RESULTS

There were significant variations in the delivery of stroke care, particularly in urban versus rural areas, as evidenced by the availability of designated stroke centers and neurologists, and stroke-related death rates. Recommendations to address variations in care delivery included the use of a common stroke data collection system, unified community education criteria, improvements to emergency medical services dispatch and training, adoption of prehospital care measures, creation of a web-based central repository of acute stroke protocols and order sets, a regional atlas of stroke resources and capabilities, a stroke patient "report card" to promote adherence to secondary prevention strategies, and explicit standards for rehabilitation services.

CONCLUSIONS

Significant disparities in the delivery of stroke care across the 8 state-region have been identified. Northeast Cerebrovascular Consortium demonstrates that multistate regional collaboration is a viable process for developing specific regional recommendations to address those disparities. Northeast Cerebrovascular Consortium is assessing the usefulness of the Stroke Systems of Care Model as a framework for implementing a regional approach to stroke across the continuum of care.