by Heather Forst, MS-HSM
Performance Improvement Program Director

In a few short months, COVID-19 went from relative obscurity to being front and center in the news and on our minds. Amid the frenzied activity of identifying, isolating and treating patients, updates are shared regularly as doctors and scientists learn more about the disease; new symptoms, potential treatments and  recovery.

Meanwhile, fear of the coronavirus has some patients avoiding hospitals altogether, delaying much-needed care just when they might need it the most. Stroke symptoms, for example, if not addressed right away, can lead to catastrophic results.

Now more than ever, it’s critical to know the signs of a stroke and remember to act FAST:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T—Time: If you see any of these signs, call 9-1-1 right away.

Patricia, or Pat to her friends, was 71 years young. Active and enjoying a life filled with grandchildren, Zumba, and volunteering, my friend’s mother Pat spent her “golden years” beautiful and happy. Other than a few minor issues, she was the picture of health.

Then one day her husband found her unresponsive after an apparent fall. At the hospital, she was diagnosed as having a stroke. While there was very little damage, the morning she was scheduled for discharge, she had another stroke. This time the outcome was worse.

After weeks of being in and out of the hospital, on and off the ventilator, rehabilitation and continued decline, Pat lost her battle. No matter how much she tried to be her mother’s advocate, my friend felt powerless to help and it was heart wrenching to witness. She not only lost her mother, but her best friend, her father’s soulmate and her children’s grandmother. “I feel older. I don’t have my mother anymore. Life has changed.”

According to the Centers for Disease Control and Prevention (CDC), each year nearly 800,000 people in the U.S. have a stroke, yet approximately 80% of strokes are preventable. Other stroke statistics include:

  • Stroke kills about 140,000 Americans each year – that’s 1 out of every 20 deaths.
  • Someone in the U.S. has a stroke every 40 seconds. Every 4 minutes, someone dies of stroke.
  • Stroke risk increases with age, but strokes can – and do – occur at any age.
  • Stroke costs the U.S. an estimated $34 billion each year. This total includes the cost of health care services, medicines to treat stroke, and missed days of work.

It is also timely to share some of the great work being done as part of the Vizient Performance Improvement Collaborative program. In 2019, 32 Vizient organizations joined a collaborative entitled Stroke: Standardizing Care, which focused on reducing clinical variations of care for stroke patients and optimizing systemwide transitions in care. During a six-month time period, collaborative participants outperformed non-collaborative organizations in reducing 30-day readmission rates for both ischemic and hemorrhagic stroke patients.

Participating members recognized stroke care has evolved significantly over the past several years due to advancements in technology, guideline updates and emerging care delivery models. Leading strategies focused on decreasing variability in early recognition and emergent response, efficient acute care management, discharge disposition planning and care transitions. Members identified the following actions needed to be taken to strengthen stroke care delivery goals and priorities:

  1. Gain regional or senior leadership participation to increase buy-in and drive program growth.
  2. Identify front-line nurse and physician champions to strengthen partnerships and implement clinical and operational improvements.
  3. Develop a reporting tool to standardize data collection, analysis and care protocols.
  4. Maintain a sense of urgency by providing real-time communication through AM and PM interdisciplinary rounds and robust reward and recognition programs.
  5. Standardize discharge planning guidelines to ensure safe transitions: offer discharge phone calls two, 30 and 60 days post-discharge to assess individualized needs. Schedule follow-up visits seven to 14 days post discharge with mid-level caregiver or physician. 

It’s important for everyone to know the signs of a stroke and provide potential victims care as quickly as possible. Even during a pandemic, if you think you or someone you know may be having a stroke, getting to a hospital for care and treatment is critical. Younger people, while they may only have mild COVID symptoms, if they experience any of the signs of a stroke, should seek immediate medical treatment.

For the latest information about COVID-19, along with valuable resources, visit the Vizient COVID-19 Resources page.

If you have additional questions about the stroke collaborative or other offerings, please contact Heather Forst.

About the author. A program director on the Vizient Performance Improvement Collaboratives team, Heather Forst develops, manages and delivers a complex set of collaborative programs to member hospitals, physician groups, and clinics. These plans include actionable business plans, along with strategic and performance improvement goals. Forst holds a master’s degree in health systems management.