Stroke is a medical emergency that requires rapid treatment — the more quickly you receive care, the better your chances of survival and long-term recovery. You can also reduce your risk of serious side effects, including permanent disabilities, by seeking care from hospitals that have proven their ability to manage even the most complex stroke cases.
Scripps Memorial Hospital La Jolla was one of the first U.S. hospitals to receive Comprehensive Stroke Center certification by the Joint Commission. This elite designation means we offer a high standard of stroke care not available at many hospitals, including minimally invasive treatments that can reopen blocked arteries, seal a ruptured blood vessel or remove a blood clot from the brain. Additionally, Scripps’ other hospitals equipped with emergency rooms are all certified as Primary Stroke Centers by the Joint Commission.
This means if you or a loved one ever needs stroke care, you can rest assured that Scripps has the advanced protocols and procedures in place to treat you quickly and effectively.
Below is some important data illustrating Scripps’ experience and performance in treating stroke patients during the 2017 fiscal year.
Scripps cares for a large number of stroke patients and has the experience necessary to diagnose and treat all varieties of stroke, no matter how complex. Among the 16 hospitals designated as “stroke receiving centers” in San Diego County, Scripps Health cared for roughly one-third of all stroke patients in 2017 fiscal year.
Scripps utilizes evidence-based guidelines endorsed by The American Heart Association and American Stroke Association, to ensure all patients suffering from stroke receive appropriate care.
At Scripps, we monitor our compliance with our “stroke core measures” as endorsed by The Joint Commission. The chart below highlights our consistent performance in exceeding standards.
Stroke core measures include:
- Venous thromboembolism (VTE) prophylaxis. The percentage of ischemic and hemorrhagic stroke patients who received a type of therapy to prevent blood clots the day of, or the day after, hospital admission.
- Discharged on anti-thrombotic therapy. The percentage of ischemic stroke patients who were prescribed a type of blood thinning medication upon discharge from the hospital.
- Number of patients prescribed anti-coagulation therapy for atrial fibrillation/flutter. The percentage of ischemic stroke patients diagnosed with a heart condition called atrial fibrillation, who were prescribed a blood thinning medication upon discharge from the hospital.
- Thrombolytic therapy. Percentage of ischemic stroke patients who arrived at the hospital within two hours of stroke symptom onset, and were given a type of “clot-busting” medicine called intravenous tissue plasminogen activator (IV t-PA) within three hours of symptom onset.
- Anti-thrombotic therapy by end of hospital day two. Percentage of ischemic stroke patients given a blood thinning medication by the end of their second day in the hospital.
- Discharge on statin medication. Percentage of ischemic stroke patients who were prescribed a medication to lower cholesterol upon discharge from the hospital.
- Stroke education. Percentage of ischemic or hemorrhagic stroke patients (or their caregivers) who were given stroke education materials during their hospital stay.
- Assessed for rehabilitation. Percentage of ischemic or hemorrhagic stroke patients who were assessed for rehabilitation needs including physical therapy, occupational therapy, and speech or swallowing therapy.
Time is brain! Clinical practice guidelines recommend hospitals administer a type of clot-busting medicine called Alteplase (tPA) to eligible ischemic stroke patients within 60 minutes of arrival.
Scripps has been recognized with the Target: Stroke Elite Plus Honor Roll and the Target: Stroke Elite Honor Roll award by the American Stroke Association for using thrombolytic therapy within 60 minutes in 75 percent or more of applicable acute ischemic stroke patients.
Ischemic strokes are caused by a blockage in one of the arteries that supply blood to the brain. Patients with evidence of blockage in one of the major blood vessels in their brain, who present within the first six hours from the onset of their stroke, can be treated with a catheter-based approach. This endovascular treatment immediately restores blood flow, captures the blood clot and removes it from the blood vessel.
Many hospitals use a scale called Thrombolysis in Cerebral Infarction (TICI) to evaluate the success of endovascular treatments. The more open a blood vessel is following treatment, the more easily blood can flow through it.
In 2015, the Endovascular Stroke Standards Committee of the Society of Vascular and Interventional Neurology established the following national benchmark for hospitals: At least 50 percent of ischemic stroke patients who undergo endovascular treatment must achieve a TICI grade of “2b” or higher. This means the vessel completely fills with blood, even though the rate of blood flow may be slower than normal.
Scripps La Jolla exceeded this goal, achieving TICI scores of 2b or higher among 94.7 percent of patients treated with endovascular procedures.