PSJH Pioneers Improvements in Stroke Treatment
By Marv Dorner
Last week was my third birthday. Well, sort of. You see, three years ago on Monday, June 8, 2015 at about 1:15 p.m. I sat down at my computer, my eyesight went crossed, I felt a little dizzy, and a few minutes later I knew I was having a stroke.
Minutes passed, and that turned to hours. I tried several times to use my smartphone to call out, but every time I thought I was dialing I would look down to see the phone on the floor instead of my hands. Something in my mind registered that an aspirin would be helpful and I had some in my truck out on the street in front of my house. Somehow, I made it to the truck, into the glove compartment where I found and took the aspirin, then I made it back into the house where I resumed trying to dial my wife, 9-1-1… anything.
Eventually, I was able to place a call to my wife, but did not leave a message. She called back and I wasn’t able to answer. She called back again and this time I answered the phone, told her (somewhat incoherently I was told) to come home. When she got there I walked to the car, looked at her and then she knew as well I was having a stroke.
When we got to the hospital I walked in to the emergency room, sat down, saw she was working with the receptionist, and totally shut down. I don’t remember much of the next couple of days, and there are parts of the years before and after those few hours I don’t remember, but I’m here today, celebrating my 3rd birthday due in large part to the physicians, nurses, and other staff at the hospital as well as all of the medical leaps that have come in the last few years in stroke treatment.
Providence Saint Joseph Health
I had the privilege of recently speaking with Bonnie Smith, VP of the Neuroscience Institute for Providence St. Joseph Health (“PSJH”). Bonnie and her team are making huge strides in new treatments for stroke and other brain injuries. The PSJH system covers over 51 hospitals in seven states. Bonnie, while not a clinician, has worked in the neurosciences for her entire career and is married to a neurologist. She very graciously spoke to me about some of the advances in the treatment of strokes.
The Providence system attracted her 13 years ago because of its willingness to offer better, more reliable methods of creating clinical pathways of treatment for neurosciences patients such that when a patient is seen in any of their hospitals, everyone is following the same quality guidelines. Providence works directly with patients and families in a more focused way as opposed to her experience within academics, and Providence has expansive research programs much like academics.
The PSJH Treatment Program
About five years ago PSJH developed a program with a goal of ensuring a client within any of the PSJH facilities can get the same level of service regardless of direct resources and locations. The National Heart Association has a benchmark of treating 50 percent of ischemic stroke patients in under 60 minutes. As a result of these communication programs PSJH has stretched that to reach a goal of treating 50 percent of eligible patients in less than 45 minutes.
The program includes PSJH hosted monthly meetings with neuroscience professionals and physicians, therapists, radiologists, cerebral vascular neurosurgeons, and more to share best practices. As a result, PSJH has developed a standard level of care practices to level the care provided across the health network. In short, this means that a patient in a more rural area will receive the same level of service as a patient in a more urban setting.
A big leap forward in the treatment of patients in rural hospitals is through the Telestroke system. It’s a teleconferencing environment that allows the physicians and other medical professionals in the PSJH system, as well as 53 additional healthcare facilities, to view the patient, communicate with local clinicians and medical staff, and even view medical charts, CT Scans and MRI’s across the Telestroke system instead of transferring the patient to a primary facility or waiting for other methods like email or a secondary digital system.
Some other new changes that PSJH has already implemented as a result of these system wide collaborations include TPA’s, coiling and stenting which can now be administered within 6 to 8 hour window instead of the previous standard of four hours. A new trial called DAWN allows certain treatments up to 24 hours of the last well known state of the patient, something unheard of in the very recent past.
Technology is Making Life Safer
My experience as a stroke patient, while not something I would want to do again, was very positive.
On the technical side, I used online resources like Lumosity to help with my memory, problem solving and other skills. I used Google Apps to document and track progress with medication, exercise and blood sugar levels. I even put the Help Me! app on all of my phones in the event I have to notify friends and family of any further issues.
The healthcare professionals who treated me did so in a very proficient, organized, almost choreographed manner. But I was lucky and in a large, somewhat urban hospital not in a small, rural healthcare facility. But it was heartening to learn of some of the advances from PSJH and other heath centers around the world. I am a fairly active outdoorsman and am often in rural locations, and knowing the Telestroke system is there or coming makes it easier for me to wander out and enjoy the great outdoors.
Technology is making our life safer, and organizations like Providence St. Joseph Health is making this possible.