Abstract 3821: Achieving the Recertification as Primary Stroke Center in Brazil.
Certification programs for Primary Stroke Centers (PSC) became a possibility after the publication of the recommendations for the establishment of PSC from the Brain Attack Coalition. The Joint Commission Organization (JCO), with the support of the AHA and ASA, launched a certification program in Dec-03. In Jan-11, more than 800 PSC were recognized in the USA. Albert Einstein Hospital in São Paulo, Brazil was the first hospital in the world to achieve the hospital accreditation quality program by Joint Commission International (JCI) outside the USA in 1999 and also was the second institution outside the USA that achieved the certification as PSC in March 2007. Albert Einstein Hospital still continues as the only certified PSC in Latin America. Our aim was to describe the actions implemented from March 2007 to March 2010 in order to obtain the recertification as PSC.
Methods/Results: We used the first version of the manual of the JCI “Disease Specific Programs” translated to Portuguese. The main actions implemented to achieve the standards required for recertification were: 1) Program management- we adopted the “Disease and the Case Management Strategies” to include the patients in the program. All patients admitted with stroke were followed by a case manager nurse since admission. A physician coordinator was hired to manage the stroke program. Neurologists were made available at the ED around the clock. 2) Delivering or facilitating clinical care: all the staff received different training programs: basic, intermediate, advanced and core stroke team. Our protocols were developed using ASA and the Brazilian Stroke guidelines. 3) Clinical information management: all the patients were prospectively evaluated and data were collected during stroke admission. 4) Supporting self-management: clinical pathways were used according to the targets of the rehabilitation program. All the risk factors were screened for and patients and families were educated and encouraged for life style changes. Education about stroke was given during admission. Educational folders and information sheets were also distributed. For smokers, we used a dedicated educational program. 5) Performance improvement and measurement: the quality indicators followed were the same as JCO and Get with the Guidelines Stroke Program. All of the 10 quality indicators used by the JCO in addition to door-image and door-needle time were also evaluated and followed since January since 2005. Monthly, quality indicators were discussed in clinical meetings and reported on the internet annually. The quality program involved tools like Lean Six Sigma and PDCA to improve the results.
Conclusion: We achieved the recertification as PSC in March 2010. We believe that the certification contributed to engage the clinical staff in offering a better assistance for all patients with stroke admitted to our service.
- © 2012 by American Heart Association, Inc.