1. TCD Missouri State Stroke Designation Teri Ackerson RN BSN TCD Program Manager

2. State Stroke Designations History Starting working on TCD – Trauma, Stroke, STEMI 2008 Projected date for Stroke was 2011 August 15, 2013 – Application process opened to apply for state stroke designation Levels I-IV March 23, 2015 – List published by the DHSS of stroke centers with level designation – EMS is to transport stroke patients to only state certified centers April 1, 2015 – State designated stroke centers are required to begin abstracting data in the Missouri Registry

3. Map of area Level I Center designations 10 Region A – 2 Region B – 0 Region C – 5 Region D – 1 Region E – 0 Region F – 2 Region G – 0 Region H – 0 Region I – 0

4. Map of Area Level II Center Designations Region A – 5 Region B – 0 Region C – 9 Region D – 2 Region E – 3 Region F – 1 Region G – 1 Region H – 1 Region I – 1

5. Map of area Level III Center Designations Region A – 2 Region B – 1 Region C – 1 Region D – 0 Region E – 1 Region F – 1 Region G – 1 Region H – 1 Region I – 0

6. Map of area Level IV Center Designations Region A – 0 Region B – 0 Region C – 0 Region D – 1 Region E – 0 Region F – 0 Region G – 0 Region H – 0 Region I – 0

7. What is new? DHSS is still collaborating with AHA – GWTG to work on mapping issues 11 anticipated applications Freeman Hospital West – level II Cox Branson – application submit level II Cameron Regional Medical Center – level III East Central County St. Louis and MARCER – Kansas City Community plans have been submitted 11 focus reviews Significant deficiencies Adequate guideline – need established practice

8. Reviewers Wanted Stroke coordinators STEMI coordinators Neurologist Neuro – interventionist Cardiologist Interventional Cardiologist ED physicians

9. Any questions please contact Please contact Nicole Gamm – Nicole.Gamm@health.mo.govNicole.Gamm@health.mo.gov