What is a Comprehensive Stroke Center?

Physician Author: Quill Turk, DO

Stroke is the fifth leading cause of death in the United States and a leading cause of adult disability. When a stroke happens, every minute it goes untreated can have a big impact on how well the person is able to recover. Getting to the right hospital quickly is vital when a person is having a stroke.

In 1995, a new clot-buster drug was approved by the FDA to treat most types of stroke. However, hospitals and doctors did not have the resources needed to rapidly evaluate  these patients and quickly provide them with this treatment. As a result, only 1-2% of people having a stroke received the medication. To increase that number, The Joint Commission created a hospital certification that gave hospitals a framework to develop teams for the prompt treatment of stroke, and lets consumers know where to find the quickest, highest-level stroke care.

This Primary Stroke Center (PSC) certification program was launched in 2003, and within a few years, 800 of the 4,000 to 5,000 hospitals in the United States had achieved this recognition. PSCs changed the culture of stroke care by making sure hospitals focus on reducing brain injury from the stroke rather than simply learning to adjust to the disability caused by the stroke.

As the science around reducing death and disability around stroke continued, it became clear that some patients with the worst types of strokes needed even more specialized care than most PSCs could offer. Over time, hospitals at the forefront of stroke care were making great improvements in treatment options. Those treatments included mechanical thrombectomy and endovascular treatment of aneurysms.

In 2012, The Joint Commission created a Comprehensive Stroke Center (CSC) certification for those hospitals that provide these extremely advanced therapies. CSCs must have doctors available 24/7 to provide cath lab and neurosurgical treatment, as well as on-site doctors trained in neuro-ICU care. Because CSCs have so many specialized doctors and team members, they are also charged with conducting research to make sure the science of stroke care continues to improve the treatments available to stroke survivors. Every Primary Stroke Center must collaborate with a Comprehensive Stroke Center so that all patients needing access to advanced care can get it.

Recently, two new designations of stroke centers were recognized to fill in the gaps for communities without access to a PSC or CSC. Acute Stroke Ready Hospitals focus on immediate care and treatment for stroke in the emergency room and transfer most stroke patients to a higher level of care. Thrombectomy Capable Stroke Centers were created for hospitals and communities that do not have all the resources and specialties needed to provide Comprehensive Stroke Center care, but can at least do mechanical thrombectomy.

It is estimated that only about 150 hospitals would be able to meet the stringent requirements to be designated a CSC. Prisma Health Greenville Memorial Hospital proudly achieved that recognition in 2017.  In order to better serve all the communities reached by Prisma Health, we are dedicated to supporting each hospital achieve the appropriate level of stroke certification that best represents the care they provide. In February, Prisma Health Greer Memorial Hospital underwent a successful on-site survey for Primary Stroke Center designation, making access to top-notch care even easier for patients in the Greer area.

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