Heterogeneity of State Stroke Center Certification and Designation Processes

Area of Science:

• Healthcare policy and administration
• Emergency medicine and neurology
• Health services research

Background:

• Stroke centers are vital for acute stroke care, improving patient outcomes.
• Variability exists in how stroke centers are certified and designated nationwide.
• Standardization is needed to ensure consistent quality of stroke care.

Purpose of the Study:

• To categorize and analyze state-level stroke center certification and designation processes.
• To identify variations in state approaches to stroke center designation.
• To provide examples of different state processes, including independent designation models.

Main Methods:

• A cross-sectional study was conducted from September 2022 to April 2023.
• Data was collected through literature review, state documents, and official communications.
• Processes were categorized across all 50 US states.

Main Results:

• Significant heterogeneity was found in stroke center certification and designation processes.
• Three main categories of state processes were identified: none, national certification-reliant, and independent/self-certification.
• Fourteen states offer self-certification or independent designation, with subcategories for different hospital levels.

Conclusions:

• State-level stroke center processes exhibit considerable diversity.
• Further research is needed to understand the impact of these process variations on stroke center rigor and clinical performance.