Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, May 22, 2015

When every second counts - MGH and MNH become specialized stroke centres

I know  hospitals like this chest-thumping display of accreditation. But that is all it is. It talks about access and procedures, NOT RESULTS and GOALS. 30day deaths and 100% recovery?
Big f*cking whoopee.
 https://muhc.ca/newsroom/article/when-every-second-counts-mgh-and-mnh-become-specialized-stroke-centres

Two McGill University Health Centre (MUHC) hospitals have recently received new accreditations: the Montreal General Hospital (MGH) was designated a secondary stroke centre and the Montreal Neurological Hospital (MNH), a tertiary stroke centre. The accreditations were granted after a successful reorganization of services that has optimized speed and quality of care for stroke patients. So, it was with great pride that around 40 members of the MUHC Stroke Program and MUHC administrators celebrated the news.
“The MUHC is the only medical institution in Quebec to have a tertiary and a secondary stroke centre,” says Neurologist Dr. Robert Côté, medical director of the MUHC Stroke Program. “Both units are ultra-specialized and provide rapid assessment, diagnostics and treatment for any type of stroke intervention. The only difference between them is that the MNH has interventional neuroradiology (INR), a procedure used to retrieve clots inside the arteries.”
The transformation of services is part of a stroke strategy put in place by the Ministry of Health in 2013 to improve stroke prevention and healthcare services offered to the more than 12,000 Quebeckers who experience a stroke every year. For every one of them, time is of essence. 
“Time is brain,” says Dr. Côté. “For every minute a stroke is left untreated, 2 million brain cells are destroyed. So, the sooner we treat patients the higher the chances of survival with fewer disabilities. That’s better for patients and their families, of course, but it’s also cost effective.”
In the last two years, a Stroke Coordinating Committee, with representatives from the MGH and MNH, worked diligently to fulfill the ministry’s long list of criteria and receive the accreditation. One important requirement was that each unit have a dedicated stroke team. 
“That means that the same professionals will follow a patient from admission until discharge,” explains Rosa Sourial, clinical nurse specialist in the MUHC Stroke Program. “Furthermore, a nurse clinician facilitates continuity of care throughout the hospitalization and collaborates with patients, families and the stroke team in planning the next phase of recovery which involves rehabilitation and follow up in the MUHC Stroke Prevention Clinic.” (Please see : Upgraded Stroke Prevention Clinic improves health services offered by the MUHC)
The two centres also reviewed and improved their procedures to fulfil three other requirements:  improve access to diagnostic testing, decrease the length of stay of patients and engage patients and families in the plan of care. (Maybe results of 60 minute delivery of tPA?)
“Although patient experience hasn’t been formally tested, a survey carried out by nurse managers in both units indicated that patients and families feel they are better informed about stroke care,” says Sourial. 
The improvements in access, continuity and quality of care in both units also benefit patients who were not initially targeted by the stroke program, such as those with transient ischemic attacks (TIA). The success in the transformation is even more meaningful because it was achieved during a challenging time. 
“We underwent the rigorous process of accreditation in a context of budget constraints and in the middle of the transition of the Royal Victoria Hospital, which was the entry point for our stroke patients, to the Glen,” says Dr. Côté. 
As Rosa Sourial puts it, the whole process has been “a lot of work, but a fun ride”.
“Our teams joined forces to improve the health of the population and we can see the results,” she says. “This is not about us, but about our patients. I hope the two stroke centres will get even better in the future.”

Upgraded Stroke Prevention Clinic improves health services offered by the MUHC
The accreditation work at the two stroke centres had another major positive result.  For the past year, the MUHC Stroke Prevention Clinic (SPC) located at the Montreal General Hospital (MGH) has been offering enhanced acute evaluation services to patients with a transient ischemic attack (TIA).
“A TIA produces similar symptoms to those of a stroke such as sudden weakness on one side of the body, face droopiness or difficulties finding words, says Heather Perkins, nurse clinician in the Stroke Prevention Clinic. “It usually lasts only a few minutes and often causes no permanent damage, but should be taken seriously, because these patients are at higher risk of having a stroke.”
The clinic accepts referrals from emergency departments and general practitioners in the community. It   has the same access to radiology and ultrasound equipment as the Emergency Department so that all exams can be done as soon as is needed. It also follows up on patients recovering from a stroke and quickly refers them to rehab specialists.
Along with the new services, the clinic pursues its main vocation: to educate healthcare workers and patients about TIAs and strokes. As Neurologist and Medical Director of the MUHC Stroke Program Dr. Robert Côté explains, “The Stroke Prevention Clinic is extremely important. We can treat patients for acute stroke and send them to rehabilitation, but we don’t want them to come back with another stroke.”


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