Primary and comprehensive stroke centers: history, value and certification criteria

Area of Science:

• Neurology
• Public Health
• Health Services Research

Background:

• Stroke care in the US has evolved substantially over recent decades.
• Advancements include new preventive therapies, mechanical clot retrieval devices, and intravenous thrombolysis for acute ischemic stroke.
• The organization of care has shifted from general neurology to specialized stroke units, teams, and pathways, with formal center designations.

Purpose of the Study:

• To provide a historical overview of organized stroke care in the United States.
• To present evidence supporting the value of primary and comprehensive stroke centers.
• To outline the certification criteria and processes for establishing these specialized stroke centers.

Main Methods:

• Review of historical developments in stroke care organization and clinical practice in the US.
• Synthesis of evidence supporting the efficacy and benefits of dedicated stroke centers.
• Analysis of certification standards and requirements set by The Joint Commission.

Main Results:

• Significant progress in stroke prevention and acute treatment, including regulatory approvals for new therapies and devices.
• Establishment and recognition of primary and comprehensive stroke centers as key components of organized stroke care.
• Development of certification processes by The Joint Commission to ensure quality standards for stroke centers.

Conclusions:

• Organized stroke care, exemplified by primary and comprehensive stroke centers, has demonstrably improved stroke outcomes in the US.
• Evidence supports the value of specialized stroke centers in delivering high-quality, coordinated care.
• Understanding the certification process is crucial for facilities aiming to achieve designation and enhance stroke care delivery.