In December 2018, the Duke Raleigh Hospital became the first hospital in North Carolina to receive Thrombectomy-Capable Stroke Center (TSC) advanced certification from The Joint Commission.
The certification, developed in collaboration with the American Heart Association/American Stroke Association (AHA/ASA) and launched January 1, 2018, recognizes hospitals that meet rigorous standards for performing endovascular thrombectomy and providing support to patients after the procedure. These standards include the following:
- Ability to perform mechanical thrombectomy 24/7
- Minimum volume of mechanical thrombectomy procedures performed
- Availability of specialized staff and clinicians with extensive trainin
- Protocol to collect, review, and submit data on patient outcomes
Duke Raleigh Hospital was evaluated during an onsite review on October 10 and 11, 2018, for compliance with the TSC requirements, which were developed with input from experts on comprehensive stroke treatment and stroke program management.
Stroke Program Manager Elizabeth Larson, BSN, RN, SCRN, says that with three endovascular-trained neurosurgeons and a neurointerventional radiology– trained radiologist, Duke Raleigh Hospital easily met The Joint Commission’s standards for highly specialized providers.
The hospital’s outcomes are also comparable to, if not better than, those of national clinical trials, she says. Using the modified Rankin Scale—the standard method for measuring neurologic deficit following stroke—Larson and her team found that, by 90 days after mechanical thrombectomy, approximately 60 percent of patients can go home and take care of themselves or are in need of minimal assistance only.
“Receiving this certification is validation from The Joint Commission that not only can Duke Raleigh Hospital offer these services, but we do it very well,” she says.
Coordinating the seven departments involved in stroke care at Duke Raleigh Hospital can be a challenge, Larson says, noting that such outcomes would not be possible without the efforts of the whole team.
“This certification is a true testament to the collaboration involved in caring for our stroke patients,” says Duke Raleigh Hospital President David W. Zaas, MD, MBA. “The dedication of the entire team—the Duke Transfer Center, the front-line ED staff, the neuro-intervention radiology team on call 24/7, the ICU and step-down nurses, and Elizabeth—enables us to have such positive outcomes.”