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Dome - Comprehensive Stroke Center Certification: First in Maryland

Dome October 2013 VOL 64
Issue No. 8

Comprehensive Stroke Center Certification: First in Maryland

Date: October 1, 2013

Victor Urrutia and Brenda Johnson discuss stroke rehab with a patient.
Victor Urrutia and Brenda Johnson discuss stroke rehab with a patient.

Every month, roughly 40 patients receive treatment at the Johns Hopkins Stroke Center, which opened in 2008. Directed by neurologist Victor Urrutia and managed by nurse practitioner Brenda Johnson, it provides treatment that includes acute stroke diagnosis, medical and surgical therapies, stroke recovery and stroke prevention. With collaboration from emergency medicine physicians, vascular neurosurgeons, interventional radiologists, neuroradiologists, neurointensivists and rehab specialists, the center’s staff evaluates and crafts a care plan for each patient. The center is located in the brain rescue unit on Zayed 12 West, and the neurosciences critical care unit on Zayed 3 West.

The center’s work was recently validated by the Joint Commission, which designated the center as a Comprehensive Stroke Center. It was the first in the state of Maryland to receive this certification. “It represents recognition of the tremendous efforts that have gone into growing and developing our stroke center,” says Justin McArthur, director of the Department of Neurology, who also praises its high level of teamwork.

In addition, says Urrutia, the designation endorses only those hospitals that provide care for the most complex strokes through advanced, rapid treatment and 24-hour, high-technology services. It singles out hospitals that “have created the infrastructure to track, evaluate and implement quality performance measures.” 

Thanks to a core team of nurses who track incidence and outcomes, clinicians and researchers can detect trends and inch closer toward a goal of giving lifesaving tissue plasminogen activator (tPA) to patients with acute stroke within 60 minutes of a patient’s arrival. This milieu also supports clinical trials and research efforts, like neurologist Steve Zeiler’s mouse models (see story at left) and other motor control and recovery studies.

The stroke center is equally committed to prevention—educating patients about risk factors—not only through its popular stroke prevention clinic, but also in the community. These efforts are critical, says Urrutia, because 20 to 40 percent of patients who suffer first-time strokes will have another within five years.

Spending extra time with these patients after they’re discharged from the hospital offers several advantages, says Johnson. With each visit, she says, patients feel more comfortable about sharing their struggles with controlling risk factors, like overeating and taking hypertension drugs. “And companions accompanying patients often help with compliance.” For many patients, says Urrutia, “stroke is a chronic disease that needs to be approached the way we treat diabetes or cystic fibrosis.”