2017 Stroke Annual Report - upstate.edu

1 2017 Stroke REPORT750 EAST ADAMS STREET, SYRACUSE, NYI esteemed Colleagues, Stroke continues to change manypeople s lives but we are winning thebattle. In 2014, Stroke fell to the fifthleading cause of death in the US. In2015, a new era of treating strokebecame the standard of care mechanical thrombectomy. In 2016 anumber of clinical trials ventured toexpand treatment windows for acutestroke management, and we continueto fight to enlarge treatmentpossibilities. On behalf of upstate University Hospital,I am pleased to present to you ourclinical achievement Report for 2017.

2 Asthe largest neuroscience team in theregion with hundreds of hospital staff, upstate University Hospital is still theonly Level 1 Comprehensive StrokeCenter, the highest level of strokecertification available. Since our initialdesignation in 2014, our program hascontinued to expand and improve ourservices to the region. Our Telestrokenetwork currently supports ninecommunity hospitals throughoutNorthern and Central NY. Our team hasbeen actively engaging the public andraising awareness of Stroke andcardiovascular disease through directeducation, public awareness campaigns,and numerous community events.

3 Atour recent Regional upstate Stroke andHealth Summit, we provided localhealthcare providers with theopportunity to network and gaincontinuing medical education. As 2016 began, we joined other Strokecenters nationally by selecting as aprimary quality improvement initiativereducing time to treatment (time tointravenous thrombolysis). Through anumber of concurrent projects whichincluded: partnering with ouremergency medical service (EMS)providers for prehospital notification,collaborating with our emergencydepartment providers to send patientsdirectly to the CT scanner from theambulance, and reorganization of ourinternal processes, we were able tosignificantly reduce our times.

4 Inpartnership with AHA Get With theGuidelines initiative, upstate StrokeProgram has been awarded the GWTG-Gold Plus and the Target Stroke ElitePlus performance award for treating100% of eligible patients with tPA within60 minutes, and 87% of eligible patientswithin 45 minutes. Our current mediantreatment time is 33 minutes. We areworking to reduce it further to less than30 commitment to Central New Yorkremains. Through our collective efforts,we envision a day when Stroke rarelyhappens. But if it does, rest assured thatwe are ready to treat are happy to share with you ouraccomplishments from this past year aswell as highlight some of our currentinitiatives during this current year.

5 Sincerely,Julius Gene Latorre, MD, MPHM edical Director, upstate Comprehensive Stroke ProgramA MESSAGE FROMTHE MEDICALDIRECTOR upstate COMPREHENSIVE Stroke CENTER2017 Stroke REPORT1 Amar Swarnkar, Director of Neuroradiology (right)and resident review a patient's CT profusion. Thewindow for Stroke rescue therapy is now wider withthe addition of innovative imaging software calledRAPID DICOM that allows treatment for some strokesup to 24 hours. The software program shows changesin brain tissue perfusion and diffusion in digitalimages captured by computerized tomography andmagnetic resonance imaging.

6 This allows doctors totell the precise area of the brain that is affected bythe Stroke , and the area still in OF CONTENTSU pstate Focuses on Academics and Research .. 2A Note from the Stroke Program Manager .. 4 Achievement Awards for Stroke Care .. 8 Stroke Quality and Outcome Measures .. 10 Working with EMS For Improved Stroke Outcomes .. 14 Stroke Care Beyond Hospital Walls .. 15 Commitment to Our Community and Region .. 16 Rehabilitation Improving Outcomes .. 20 Meet Our Stroke Team .. 24 2 upstate COMPREHENSIVE Stroke CENTERU pstate University Hospital, as part ofSUNY upstate Medical University, is theonly academic medical center in theCentral New York Region and is one of theoldest medical schools in New York.

7 Thiscommitment to education is anchored bythe four colleges: Medicine Nursing Health Professions Graduate StudiesAs an academic medical center we havethe opportunity to offer many of ourpatients participation in clinical types of research studies can help todetermine whether new drugs ortreatments are safe and effective. Ourresearch focuses on diseases that affectour local community such as Stroke ,diabetes, and cancer. upstate University Hospital has long heldthe distinction of caring for the mostseriously ill and injured patients in NewYork State.

8 We serve a region that coversover one-third of our state. upstate is the region s only: Level I Comprehensive Stroke Center Level I Trauma Center Burn Center Poison Control Center Children s HospitalIt is our mission to continue to strive toprovide the best care possible and to meetor exceed the needs of our patients andour FOCUSES ON ACADEMICS AND RESEARCH2017 Stroke REPORT3 upstate has an entire hospital floor dedicatedto the is the only Level I Comprehensive StrokeCenter in Central New York. The internationalaccreditation organization (DNV) confirmsUpstate provides the most advanced andhighest quality Stroke care in Central New York.

9 History of UpstateWhen the hospital opened in1964, it was the first hospital inCentral New York to combineresearch, in-patient facilities andout-patient treatment. Thebuilding cost $20,000,000 andtook four years to the 1970s upstate made asignificant commitment to theneurosciences by establishingthe first dedicated neuro-intensive care unit. In 2006,furthering our commitment toneurosciences, upstate becamethe first designated Stroke centerin Central New York. ResearchOur neurosurgical team offerspatients the most advanced skillsand technology available scientists aim to bring themeven more tumors are just one of theresearch areas being explored byUpstate s is at the core ofacademic medicine and improveshealth through new insights the largest and longestestablished neurosurgery center and as part of the region s onlymedical university upstate sfaculty also bring the mostadvanced skills and technologyto patient care.

10 4 upstate COMPREHENSIVE Stroke CENTEROur mission as the region s only Level IComprehensive Stroke Center is toprovide the highest level of care possibleto Stroke patients in the Central NewYork Region. The staff of The StrokeProgram consist of multidisciplinaryexperts to ensure that we consistentlymeet and exceed national qualitybenchmarks in Stroke 2016, upstate s Comprehensive StrokeCenter saw: 1489 actual and presumptive strokepatients 550 acute ischemic strokes 200 hemorrhagic strokes 100 TIAs And accepted 525 transfers from otherhospitals in our regionThis means we have vast experience incaring for Stroke patients and theirfamilies.