NewsDetail
In recent years Hamad Medical Corporation (HMC) has made significant advances in its efforts to provide the very highest standards of care for stroke patients. Analysis of data compiled from every stroke patient admitted to HMC highlights the quality of care being of the highest international standards.
The recruitment of specialist nurses and expert consultants, the opening of dedicated facilities and introduction of advanced technology - including a dedicated stroke ward, a telemedicine service and a Neuroangiograhy Suite – as well as the redesign of care processes, have all delivered improved outcomes for stroke patients in Qatar.
“We are incredibly proud of the progress our stroke service has made recently,” said Dr. Yousef Al Maslamani, Medical Director at Hamad General Hospital (HGH). “Stroke is a serious condition affecting significant numbers of people in Qatar and we are committed to ensuring that these patients receive the very highest standard of treatment when they come to us in their time of need,” he explained.
A stroke database set up to track and improve the outcomes of patients provides the stroke team with in-depth data on every stroke patient admitted to HMC and enables them to analyze this data and recognize significant trends.
“Our data highlights that a number of key indicators for successful care outcomes either meet or exceed international standards,” stated Professor Ashfaq Shuaib, Director of HMC’s Neurosciences Institute. One of these indicators is the ‘door to needle time’. This is the length of time that passes between when an acute stroke patient arrives at the emergency department to when they receive specialist treatment.
“The assessment, evaluation and imaging of acute stroke patients is a very complicated process. Because of this complexity, the American Stroke Association sets a target for hospitals to treat approximately 50 percent of acute stroke patients in under 60 minutes,” explained Prof Shuaib.
“In early 2014 our stroke program began an integrated program to improve the door to needle times for acute stroke patients. In the two years since the program was implemented, the team has consistently achieved times of less than 40 minutes for 44 percent of patients and under 60 minutes for 68 percent of patients. This compares very favorably to the majority of tertiary stroke centers in Europe and North America, which achieve this 60-minute door to needle goal only 50 to 60 percent of the time,” said Prof Shuaib.
The rationale behind the need for fast treatment of stroke patients is that ‘time is brain’, meaning the faster treatment can be given following a stroke, the better the chances of recovery are for patients. The sooner acute stroke patients can be given thrombolysis, a clot breaking drug, to open the artery and renew blood flow to the brain, the better the outcome for them.
“Speed of thrombolysis treatment is the key, as it must be given within four and a half hours of the onset of symptoms. Many tertiary stroke centers in Europe and North America treat 10 to 15 percent of their acute stroke patients with thrombolysis, while very few treat more than 20 percent of their patients,” said Prof Shuaib.
“To date in 2016 at HGH, our stroke program has treated 23 percent of acute stroke patients with thrombolysis, meeting the highest international standards,” he stated.
Another area in which HMC’s stroke service performs well when compared to international standards is in the average length of stay of patients. A short length of stay demonstrates the effective nature of the care being given. Patients benefit greatly from being discharged as early as possible, when clinically appropriate, to continue their recovery at home with ongoing support from the care teams.
“International research has consistently shown that a stroke ward, with a specialist stroke team, leads to improved patient care through better diagnosis, avoidance of medical complications - the single most important cause of delay in discharge - and early discharge of patients,” said Dr. Naveed Akhtar, head doctor at the HGH Stroke Ward.
“The average length of stay for stroke patients was 11 days prior to the establishment of our Stroke Ward in March 2014. Through the introduction of the ward and the formation of a dedicated stroke team, the length of stay over the last two years has declined to between just five and six days. This is comparable with the best stroke programs in the world,” explained Dr. Akhtar.
