A Stroke Care Model at an Academic, Comprehensive Stroke Center During the 2020 COVID-19 Pandemic.
Academic Medical Centers
Betacoronavirus
/ pathogenicity
COVID-19
California
Coronavirus Infections
/ diagnosis
Critical Pathways
/ organization & administration
Delivery of Health Care, Integrated
/ organization & administration
Health Services Needs and Demand
/ organization & administration
Host-Pathogen Interactions
Humans
Infection Control
/ organization & administration
Infectious Disease Transmission, Patient-to-Professional
/ prevention & control
Models, Organizational
Needs Assessment
/ organization & administration
Neurology
/ organization & administration
Occupational Exposure
/ adverse effects
Occupational Health
Pandemics
Patient Safety
Pneumonia, Viral
/ diagnosis
Risk Assessment
Risk Factors
SARS-CoV-2
Stroke
/ diagnosis
Time Factors
COVID-19
Stroke
Stroke code
Systems of care
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
03
04
2020
revised:
08
04
2020
accepted:
29
04
2020
pubmed:
22
5
2020
medline:
30
7
2020
entrez:
22
5
2020
Statut:
ppublish
Résumé
The COVID-19 pandemic has required the adaptation of hyperacute stroke care (including stroke code pathways) and hospital stroke management. There remains a need to provide rapid and comprehensive assessment to acute stroke patients while reducing the risk of COVID-19 exposure, protecting healthcare providers, and preserving personal protective equipment (PPE) supplies. While the COVID infection is typically not a primary cerebrovascular condition, the downstream effects of this pandemic force adjustments to stroke care pathways to maintain optimal stroke patient outcomes. The University of California San Diego (UCSD) Health System encompasses two academic, Comprehensive Stroke Centers (CSCs). The UCSD Stroke Center reviewed the national COVID-19 crisis and implications on stroke care. All current resources for stroke care were identified and adapted to include COVID-19 screening. The adjusted model focused on comprehensive and rapid acute stroke treatment, reduction of exposure to the healthcare team, and preservation of PPE. The adjusted pathways implement telestroke assessments as a specific option for all inpatient and outpatient encounters and accounts for when telemedicine systems are not available or functional. COVID screening is done on all stroke patients. We outline a model of hyperacute stroke evaluation in an adapted stroke code protocol and novel methods of stroke patient management. The overall goal of the model is to preserve patient access and outcomes while decreasing potential COVID-19 exposure to patients and healthcare providers. This model also serves to reduce the use of vital PPE. It is critical that stroke providers share best practices via academic and vetted social media platforms for rapid dissemination of tools and care models during the COVID-19 crisis.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
The COVID-19 pandemic has required the adaptation of hyperacute stroke care (including stroke code pathways) and hospital stroke management. There remains a need to provide rapid and comprehensive assessment to acute stroke patients while reducing the risk of COVID-19 exposure, protecting healthcare providers, and preserving personal protective equipment (PPE) supplies. While the COVID infection is typically not a primary cerebrovascular condition, the downstream effects of this pandemic force adjustments to stroke care pathways to maintain optimal stroke patient outcomes.
METHODS
METHODS
The University of California San Diego (UCSD) Health System encompasses two academic, Comprehensive Stroke Centers (CSCs). The UCSD Stroke Center reviewed the national COVID-19 crisis and implications on stroke care. All current resources for stroke care were identified and adapted to include COVID-19 screening. The adjusted model focused on comprehensive and rapid acute stroke treatment, reduction of exposure to the healthcare team, and preservation of PPE.
AIMS
OBJECTIVE
The adjusted pathways implement telestroke assessments as a specific option for all inpatient and outpatient encounters and accounts for when telemedicine systems are not available or functional. COVID screening is done on all stroke patients. We outline a model of hyperacute stroke evaluation in an adapted stroke code protocol and novel methods of stroke patient management.
CONCLUSIONS
CONCLUSIONS
The overall goal of the model is to preserve patient access and outcomes while decreasing potential COVID-19 exposure to patients and healthcare providers. This model also serves to reduce the use of vital PPE. It is critical that stroke providers share best practices via academic and vetted social media platforms for rapid dissemination of tools and care models during the COVID-19 crisis.
Identifiants
pubmed: 32434728
pii: S1052-3057(20)30333-5
doi: 10.1016/j.jstrokecerebrovasdis.2020.104927
pmc: PMC7205687
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
104927Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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