Accreditations

Akron General Medical Center is a Primary Stroke Center with the Gold Seal of Approval™ from Joint Commission.

Our Stroke Team, including board certified critical care physicians, is available 24 hours, seven days a week, and is able to evaluate a patient presenting with stroke symptoms within five minutes of their arrival.

Compare Akron General with National Standards:

Brain Imaging Media
Physician Availability for Interpretation of Brain Imaging Studies
Stroke Disease Management
Tpa (Clot-dissolving Medication)
Neurologist on Staff
Neurologist Board Certification
Patient and Community Education
Inpatient Mortality
Length of Stay
Stroke Center
Stroke Rehabilitation Program
Aspirin Given within 48 Hours of Admission for Stroke
Antithrombotic Medication Prescribed at Discharge
Vascular Neurologist Available

1. Brain Imaging Media
According to the American Stroke Association’s "Guidelines for the Early Management of Patients With Ischemic Stroke," a brain imaging study is mandatory in order to distinguish ischemic stroke from hemorrhagic stroke or from other brain conditions that may mimic stroke. "Brain imaging is required to guide acute intervention. For most cases and at most institutions, computerized tomography (CT) remains the most important brain imaging test."

According to the guidelines, "because time is of the essence in acute stroke care, institutions should have these diagnostic studies available on a 24-h/day and 7-d/week basis." (Stroke, April 2003: 34(4); 1056-1083)

Akron General Medical Center has 24-h/day 7-d/week radiology services available for brain imaging, including computerized tomography (CT), CT antiography, magnetic resonance imaging (MRI), open MRI, MR angiography (MRA), ultrasound and the area’s only 64-slice Volume Computed Tomography (VCT) scanner.

2. Physician Availability for Interpretation of Brain Imaging Studies
For most cases and at most institutions, computerized tomography (CT) remains the most important brain imaging test. A physician skilled in assessing CT studies should be available to interpret the scan. (Stroke, April 2003: 34(4); 1056-1083)

Akron General Medical Center offers 24-h/day 7-d/week coverage by radiologists skilled in the interpretation of brain computerized tomography (CT) scans and other brain imaging tests.

3. Stroke Disease Management
Disease management programs are increasingly being examined and introduced to help treat chronic illnesses such as cardiovascular diseases and stroke. "The term ‘disease management programs’ typically refers to multidisciplinary efforts to improve the quality and cost-effectiveness of care for select patients with chronic illness." (Circulation, June 1, 2004: 109(21); 2651-2654)

Akron General Medical Center offers a comprehensive disease management program for stroke patients that works to improve the quality of care and patient outcomes by using evidence-based interventions and a multi-disciplinary approach, and by encompassing all aspects of care required to obtain optimal levels of health and functionality.

4. Tpa (Clot-dissolving medication)

Stroke occurs when blood flow to the brain is disrupted. Disruption in blood flow is caused when either a blood clot or piece of plaque blocks one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke) (Neurology, 2005; 64: E1-E2).

Intravenous tissue plasminogen activator or tPA (also known as a "clot-buster" medication) is currently the only agent approved by the US Food and Drug Administration (FDA) for treating acute ischemic stroke. tPA should be administered within three hours of onset of acute ischemic stroke in patients who meet certain eligibility requirements (New England Journal of Medicine, September 7, 2000: 343(10); 712-722).

Nationwide, 10 to 20 percent of eligible ischemic stroke patients receive tPA (Stroke, November 2005: 36(11); 2500-2503).

Tissue plasminogen activator is not generally used for hemorrhagic stroke or in those who may experience bleeding problems because it may increase bleeding. A CT scan or MRI of the brain is needed to quickly determine if an individual is having an ischemic or hemorrhagic stroke.

The pooled results of three major tissue plasminogen activator (tPA) trials confirmed that early stroke treatment is strongly associated with favorable stroke outcomes (The Lancet, March 6, 2004: 363(9411); 768-74).

Akron General Medical Center uses tPA to treat ischemic stroke patients when appropriate, according to national guidelines. 100% of eligible acute ischemic stroke patients at Akron General Medical Center receive tPA according to national guidelines.

5. Neurologist on Staff
Studies have shown that stroke patients who are treated primarily by a neurologist have better outcomes, both short-term and long-term. (Neurology, September 23, 2003: 61(6); 792-796; Stroke, November 1996: 27(11); 1937-1943)

Akron General Medical Center has 20 neurologists on staff.

6. Neurologist Board Certification
A board-certified physician has completed an approved educational training program and an evaluation process including an examination designed to assess the knowledge, skills, and experience necessary to provide quality patient care in that specialty. A specialty certificate is issued by a medical specialty certifying board, which is valid nationwide. Although certification is not required for an individual physician to practice medicine, most hospitals and managed care organizations require that at least a certain percentage of their staff be "board certified" (American Board of Medical Specialties).

80% of Akron General Medical Center's neurologists are board certified in Neurology by the American Board of Psychiatry and Neurology.

7. Patient and Community Education
According to the latest statistics from the American Stroke Association:

• Each year about 700,000 people have a new or recurrent stroke.
• Stroke killed approximately 158,000 people in 2005.
• Stroke is the third leading cause of death in the US.
• Millions of brain cells die each minute stroke is untreated.
  

Symptoms of a stroke include the following:

• sudden numbness or weakness of the face, arm, or leg, especially on one side of the body;
• sudden confusion, trouble speaking or understanding;
• sudden trouble seeing in one or both eyes;
• sudden trouble walking, dizziness or loss of balance or coordination;
• sudden severe headache with no known cause.
  

"Only about one-third of patients who are having a stroke are aware of its symptoms, and most bystanders are not knowledgeable about the signs of stroke" (New England Journal of Medicine, September 7, 2000: 343(10); 710-722).

A person experiencing a stroke may be unaware of the stroke symptoms or unable to communicate and it is often bystanders who initiate communication for stroke care (Archives of Internal Medicine, October 13, 2003: 163(18); 2198-2202).

Studies have shown an increase in public awareness of stroke symptoms and the need for emergent stroke treatment, as well as improvement in stroke care delivery after certain types of community educational interventions (Archives of Internal Medicine, October 13, 2003: 163(18); 2198-2202); Stroke, August 2003: 34(8); 1968-1969; Critical Care Nursing Quarterly, October/November/December 2003: 26(4); 316-322).

The pooled results of three major tissue plasminogen activator (tPA) trials confirmed that early stroke treatment is strongly associated with favorable stroke outcomes (NOTE: tPA is "clot-buster" medication used to treat ischemic stroke in certain situations.) (The Lancet, March 6, 2004: 363(9411); 768-74).

Akron General Medical Center actively participates in stroke education programs through community support groups, community education efforts and community screenings.

Akron General Medical Center is also an accredited Stroke Center by Joint Commission.

8. Inpatient Mortality
The mortality rate (measured as a percentage) provides general information about the quality of care delivery, and can be an important quality indicator. However, some hospital care for patients with a greater severity of illness and therefore may have a higher mortality rate.

According to the most recent national data from the Healthcare Cost and Utilization Project’s (HCUP) Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality (AHRQ), the inpatient mortality rate for stroke in the US was 10.74 percent.

The inpatient mortality rate for stroke at Akron General Medical Center was 10.6 percent in 2006, which is better than the rate for stroke in HCUP’s Nationwide Inpatient Sample.

9. Length of Stay
According to the most recent national data from the Healthcare Cost and Utilization Project’s (HCUP) Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality (AHRQ), the average length of stay (ALOS) for stroke in the US was 6.4 days.

In 2006, the average length of stay for stroke patients at Akron General Medical Center was 4.9 days, which is better than the national ALOS for stroke in HCUP’s Nationwide Inpatient Sample.

10. Stroke Center
The Brain Attack Coalition, a multidisciplinary group dedicated to improvements in stroke care, supports the development of primary and comprehensive stroke centers. Primary stroke centers provide basic stroke care and refer to a comprehensive center as needed. A comprehensive stroke center provides a complete range of care for complex stroke patients requiring specialized testing and interventions at all levels.

Some of the key elements recommended by the Coalition for primary stroke centers are:

• Acute stroke team
  Includes a physician and one or more other healthcare professionals (i.e., nurse, physician's assistant, nurse practitioner) who are available on an around-the-clock basis.
  
• Written care protocols
  
• Emergency medical services (EMS)
  It is vital that EMS have effective communication with the Emergency Department during transportation of suspected stroke patients.
  
• Emergency department
  ED personnel should be well trained in the diagnosis and treatment of all types of stroke.
  
• Stroke unit
  Studies have shown that stroke patients who receive care in a specialized stroke unit had decreased rates of death, decreased lengths of stay, and increased rates of being able to live at home after the stroke.
  
• Neurosurgical services
  Because some patients with acute stroke will require evaluation and/or intervention by a neurosurgeon, neurosurgical care should be available within two hours of such a requirement being deemed necessary, either onsite or by transfer to another facility.
  
• Medical organization commitment to and support of the primary stroke center.
  
• Neuroimaging
  The primary stroke center should be able to provide either a cranial computerized tomography (CT scan) or brain magnetic resonance imaging (MRI) within 25 minutes of the order being written on an around-the-clock basis. In addition, physicians with experience in interpretation of CT and/or MRI studies should be available to interpret the scans within 20 minutes of their completion.
  
• Laboratory services
  Available 24/7
  
• Outcomes and quality improvement
  
• Educational programs
  The stroke center's professional staff should receive a minimum of eight hours/year of continuing education programs to maintain and expand their knowledge of stroke care (JAMA, June 21, 2000: 283(23); 3102-3109).
  

Akron General Medical Center offers a primary stroke center for the diagnosis and treatment of acute stroke patients, including a stroke unit.

12. Aspirin Given Within 48 Hours of Admission for Stroke
Patients who are admitted to a hospital for acute ischemic stroke should receive aspirin within 48 hours of admission, unless contraindications for receiving aspirin, including, but not limited to, allergy to aspirin or gastrointestinal bleeding, are present. Patients who meet the criteria should continue to receive aspirin on a daily basis (Circulation, 2006; 113:e409-e449).

Unless otherwise contraindicated, the protocol at Akron General Medical Center includes the administration of aspirin to ischemic stroke patients within 48 hours of admission to the hospital.

13. Antithrombotic Medication Prescribed at Discharge (stroke preventing drugs)
Because of the risk for recurrence of stroke after an ischemic stroke has occurred, antiplatelet medication is recommended to reduce this risk. Antiplatelet therapy reduces the risk of a recurrent stroke by more than 20 percent. (Journal of Vascular and Interventional Radiology, January 2004: 15(1, Part 2); S87-S101)

Unless otherwise contraindicated, the protocol at Akron General Medical Center includes prescribing antithrombotic medication for ischemic stroke patients when they are discharged from the Hospital.

14. Vascular Neurologist Available
Vascular neurology is a new medical subspecialty that provides focused expertise for stroke care and other conditions. The American Board of Psychiatry and Neurology defines this new physician role as one that evaluates and treats persons with vascular diseases of the nervous system.

Physicians who are board certified vascular neurologists have extensive training in treating vascular events from ischemic stroke, intracranial hemorrhage, spinal cord ischemia, and spinal cord hemorrhage.

Akron General Medical Center has a board certified vascular neurologist on staff or available for consultation.