Continuum of Care: Stroke

Healthy Population

At-Risk Population

Stroke Event

EMS Emergency Department

Hospital Rehabilitation

Healthy Population

Primordial Prevention– Prevention of risk factor development– Awareness of stroke risk

At-Risk Population

Primary Prevention– Prevention of event– Control of risk factors– Awareness of stroke risk

Stroke Event Occurs

Secondary Prevention– Recognition of Stroke Signs and

Symptoms– Recognition to call emergency response

Emergency Medical Services

Secondary Prevention– Acute Care and Treatment

Emergency Department

Secondary Prevention– Acute Care and Treatment

Hospital Stay

Secondary Prevention– Sub-Acute Care

Rehabilitation

Secondary and Tertiary Prevention

General/Healthy Population

At-Risk Population Stroke Event EMS Emergency Department

Hospital Rehabilitation

Develop a follow-up support system for stroke survivors and families. (Individual help and group)

Partnership with professional sports or community events that provide major exposure.

Identify priority needs for culturally-appropriate education materials.

Training for EMS professionals, police and fire personnel.

Training for ED professionals, especially on tPA

Training for hospital based stroke professionals

Training for stroke rehabilitation professionals, long term care personnel.

Insurance coverage for stroke screenings (over age 50)

Develop statewide EMS protocols for stroke, and use of stroke scales.

Improved coverage for ambulance calls for stroke.

Legislatively mandate pre-arrival instructions.

Implementation of Get With The Guidelines - Stroke.

Communication system among rehab specialists and managed care organizations for better care coordination.

Educate older adults about stroke treatment options.

Dispatcher education. State-based collaborative on stroke care improvement (include clinics and hospitals)

Family Education

Educate long term care workers.

Educate hospital workers, urgent care clinics, health "help line" services.

Communication protocols/network between small and large hospitals

Survivor education and support.

Add stroke measures to critical access care hospital measures for CMS.

Maintain list of specialized services available throughout state.

Conduct a "call 9-1-1" and warning signs awareness media campaign. Develop an integrated acute stroke care network for EMS and hospitals.

Guidelines for Project Development

Identify a lead organization Action plan to be presented to a

potential lead organization MDH will support, coordinate, and

advise on each project

Guidelines for Project Development

Collaboration with multiple organizations is encouraged

Funding: (a) Partner Organizations

(b) Foundations, and/or

(c) State/Federal Agencies(e.g., CDC)

Role of Minnesota Stroke Committee on Projects

1. Initiate and Develop

2. Coordinate or Implement

3. Advise

4. Monitor, and/or

5. Evaluate

Updated: January 2006