With May being American Stroke Month, the American Stroke Association and American Heart Association are placing a special emphasis on broadcasting prevention strategies and promoting symptom awareness. Though hospitals and health systems are similarly concentrating on prevention efforts, many are also working to gain The Joint Commission’s new stroke certificate: Thrombectomy-Capable Stroke Center.
Created in collaboration with ASA and AHA, the TCS certificate went live on January 1, 2018 and joins TJC’s three existing certifications: Acute Stroke Ready Hospital, Primary Stroke Center, and Comprehensive Stroke Center. To earn one of these three prestigious certificates, organizations must demonstrate fulfillment of a number of criteria and undergo an extensive survey process. The new certificate—which focuses specifically on mechanical thrombectomy for patients with large vessel occlusive ischemic strokes—is just as difficult to obtain but is also vital to improving patient access to stroke care, as highlighted below.
- Criteria Needed to Earn the TCS Certificate: Per TJC, organizations who gain the TCS certification must have completed mechanical thrombectomy and post-procedure care for at least 15 patients with ischemic stroke in the past 12 months or 30 patients in the last year. Additional requirements include 24/7 acute stroke team and neurologist availability, designated stroke beds, appropriate diagnostic services, IV thrombolytics accessibility, and tracking and reporting performance measures.
- What to Consider Before Working Toward the Certificate: According to David Baker, MD, MPH, FACP, executive vice president for Healthcare Quality Evaluation at TJC, this certification should only be pursued by hospitals and health systems that have an established history of performing mechanical thrombectomy, so organizations should not
start conducting the procedure for the sole purpose of gaining this certification. Dr. Baker also contends that organizations who wish to be TCS certified must have a working relationship with EMS in order to receive the necessary amount of patients. Additionally, he says that organizations should conduct a cost analysis to ensure that they have the funds to support annual 24/7 stroke care coverage.
- Why the Certification Was Developed: The TCS certification was created in the wake of recent studies that demonstrated the efficacy of mechanical thrombectomy in treating LVO ischemic stroke. Despite this research, only about one-third of primary stroke centers can perform the procedure, limiting the quick timing that is essential to effective stroke care.
- How It Accelerates Access to Stroke Care: The new certification speeds up access to care by alerting EMS of which hospitals and health systems can perform mechanical thrombectomy, thus reducing
unnecessary transfers from primary or comprehensive stroke centers that cannot perform the procedure. According to TJC, the TCS certification improves patient access because it expands and diversifies the network of stroke-certified hospitals, a sentiment echoed by the AHA/ASA’s Hospital Accreditation Stroke Committee’s chair Edward C. Jauch, MD in a press release.
“In large areas of the country, people who suffer LVO strokes face longer travel times to reach a comprehensive stroke center, which lessens their chance for a rapid thrombectomy and better outcomes,” said Dr. Jauch. “Meanwhile, hospitals well-equipped to treat patients with LVO strokes may be bypassed because they do not meet existing requirements for comprehensive stroke center certification. The new Thrombectomy-Capable Stroke Center certification will help ensure that patients who need it can get timely treatment wherever they live.”
- The Certificate Was Released in Conjunction With New Guidelines: Soon after the TCS certificate was announced, the AHA and ASA released new recommendations for the timeline of mechanical thrombectomy treatment. These guidelines extend the timeframe of patient ability to receive the procedure from less than six hours post-stroke to up to 24 hours for LVO ischemic stroke patients.
If you are interested in pursuing this new certification, HBI’s Cost & Quality Academy is here to help! Last year, we published an E-Book highlighting strategies three leading organizations utilized to gain TJC stroke center certifications. Though this E-Book was published before the advent of the TCS certification, its content is still applicable.