Original article by:HealthLeaders Media
The Joint Commission has created a Thrombectomy-Capable Stroke Center (TSC) certification.
David Baker, MD, executive vice president for Health Care Quality Evaluation at The Joint Commission, said the new certification program was developed after surveys showed that one-third of certified primary stroke centers routinely performed endovascular thrombectomies (EVTs).
“Multiple studies have proven EVT treatment to be effective in saving lives and lowering disability from stroke, particularly if performed within 6 hours of the last time the patient was known to be well. This certification was developed in response to a revolutionary technology and trying to make sure that everyone has good access to that technology in a time frame that is going to achieve optimal outcomes.”
Baker spoke about the new TSC certification. The following is an edited transcript.
What hospitals should consider this certification program?
Right now, one third of our primary stroke centers are doing mechanical thrombectomies. We are looking for the strongest hospitals in that group — the ones that are able to do high-quality thrombectomies and post-procedure care. They’ve got substantial volume with strong experience. Importantly for us, this was originally developed to address areas where there wasn’t good access to a comprehensive stroke center.
What are the advantages to mechanical thrombectomies?
In 2015 three landmark studies showed that for patients who have the worst strokes — basically clots in one of the big blood vessels in the neck or the brain — a very large part of the brain is affected by this, and the patients will be devastated by this.
These studies showed, and I am not overstating this, some of the most dramatic improvements that we have seen with any therapy. So, if you can get somebody to a hospital who can do this procedure — they put a catheter into the large vessel, and they remove that blood clot so it restores blood flow to that area of the brain that is affected — if you look at the numbers of people who were able to regain almost complete function, it’s a vast improvement.
What should hospitals look at internally when deciding to pursue this?
This is probably something that would be taken up by hospitals already doing these procedures. Hospitals are going to have to make sure they can provide 24/7 coverage. Ideally, there should be a working relationship with EMS so that they know that if they gear up and can do this with 24/7/365 coverage and [are prepared for] the costs associated with that, that they are going to get the volume of patients.
The calculation is how many patients are we seeing? How many more patients would we see if we got this designation, and will our emergency transport system recognize that? Particularly in some of these rural areas, if there was something there, it would get a lot of traffic.
How does this accelerate access to proper care?