Minnesota Acute Stroke System Council August 24, 2011
Agenda Review of progress to date Survey Results Discussion: pre-notification Discussion: acute treatment protocols Announcement: stroke initiatives structure Next Steps
Objectives 1.Consensus on pre-notification 2.Consensus on acute treatment protocol elements 3.Informed of organizational structure for stroke initiatives in Minnesota 4.Understand next steps for MASSC
Survey N=55 hospitals represented on Council (~43% of acute care hospitals in Minnesota) Responses: 20 (45%)
EMS Pre-Notification
What types of information differs? Information from ALS vs. BLS Blood sugar; medical history; last known well/time of onset; stroke scale Color (red/yellow/green) coding; “code grey” vs. “code stroke” vs. other
How does receiving differing information impact care?* Delays time to diagnosis Sometimes causes delay in treatment Lack of clarity may impact preparation time *Most commented more generally about how pre-notification improves lab, diagnosis, and treatment times, not about the impact of having inconsistent/varying pre- notification information)
Do we need to have a single protocol or standards for pre-notification?
Selected comments about having standards for EMS pre-notification Would be helpful to know time of onset, BP, minute notification It’s a no-brainer! Would be helpful for all patients Need to be sensitive to resources available to various EMS systems Essential Help smaller EDs in planning Need standardization of care, standard screens Standardization would ensure appropriate assessments are done, including the most important information
Discussion: pre-notification Comments Standards vs. a statewide protocol What “product” should we adopt/develop? Process: working group
“Please list minimum elements for a diagnosis/treatment protocol” Comments “Standards” What “product” should we adopt/develop? Process: working group
CT availability
Next Steps September: transport protocol October: discussion of first drafts of products – EMS pre-notification standards; – Treatment protocol standards; – Transport protocol November: ?