Gropen Toby, Magdon-Ismail Zainab, Day David, Melluzzo Shannon, Schwamm Lee H
Department of Neurology, Stroke Center, Long Island College Hospital, Brooklyn, NY 11201, USA.
Stroke. 2009 May;40(5):1793-802. doi: 10.1161/STROKEAHA.108.531053. Epub 2009 Mar 19.
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.
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.
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.
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.
东北脑血管联盟的成立旨在研究地区差异，并根据卒中照护系统模型推荐改善卒中护理的策略。
2006年首次举办年度峰会，汇集了公共卫生官员、研究人员、医生、护士、卫生专业人员、州立法者和倡导组织。介绍了卒中照护系统模型各组成部分内的最佳实践和循证干预措施。六个写作小组负责梳理每个州目前的活动，并确定该地区的目标。
卒中护理的提供存在显著差异，尤其是在城市和农村地区，指定卒中中心和神经科医生的可及性以及卒中相关死亡率证明了这一点。针对护理提供差异的建议包括使用通用的卒中数据收集系统、统一的社区教育标准、改善紧急医疗服务调度和培训、采取院前护理措施、创建基于网络的急性卒中方案和医嘱集中央存储库、卒中资源与能力区域地图集、促进二级预防策略依从性的卒中患者“成绩单”以及康复服务的明确标准。
已确定该8个州地区在卒中护理提供方面存在显著差异。东北脑血管联盟表明，多州区域合作是制定解决这些差异的具体区域建议的可行过程。东北脑血管联盟正在评估卒中照护系统模型作为在整个护理连续过程中实施区域卒中方法框架的实用性。
