Pharmacists' role in a hospital's initiative to become a certified primary stroke center

Abstract

Purpose: Significant pharmacy department contributions to a medical center's efforts to attain certification as a primary stroke center (PSC) are described.

Summary: As part of an initiative to improve outcomes in patients with stroke and earn the PSC designation, the pharmacy department of an 855-bed community teaching hospital participated in developing a multifaceted "Code Stroke" program. Pharmacists deployed in the emergency department (ED), intensive care units, and medical units are involved in all aspects of stroke care from admission to discharge. Pharmacists attend ED responses to Code Stroke alerts, assisting in patient evaluation and helping to ensure timely tissue plasminogen activator (t-PA) administration and prompt computed tomography scanning. Throughout the hospital stay of a patient with stroke, pharmacists are involved in verifying that applicable Joint Commission core measures are met. Once a patient with stroke is deemed ready for discharge, a transitions-of-care pharmacist ensures that the patient receives the assistance necessary to obtain newly prescribed medications and counseling to promote postdischarge compliance. Implementation of the Code Stroke program was associated with improvements in stroke care quality measures, including a reduction in the median time from hospital arrival to t-PA administration and improved core measure compliance.

Conclusion: By participating in the implementation of a number of transformative initiatives, the pharmacy department played an important role in enabling the medical center to provide consistent, excellent care for all patients with stroke as it prepared for certification as a PSC.