The Joint Commission's Primary Stroke Center Certification Program, launched in December 2003, was developed in collaboration with the American Heart Association/American Stroke Association (AHA/ASA). As of October 1, 2009, there are more than 600 certified primary stroke centers in 49 states. Certification is available only to stroke programs in Joint Commission-accredited acute care hospitals.
The Certificate of Distinction for Primary Stroke Centers recognizes centers that make exceptional efforts to foster better outcomes for stroke care. It is The Joint Commission’s first advanced certification program. Programs applying for advanced certification must meet the requirements for Disease-Specific Care Certification plus additional, clinically specific requirements and expectations. Certified primary stroke centers:
- Use a standardized method of delivering care based on the Brain Attack Coalition recommendations for establishment of primary stroke centers.
- Support a patient’s self-management activities.
- Tailor treatment and intervention to individual needs.
- Promote the flow of patient information across settings and providers, while protecting patient rights, security and privacy.
- Analyze and use standardized performance measure data to continually improve treatment plans.
- Demonstrate their application of and compliance with the clinical practice guidelines published by the AHA/ASA or equivalent evidence-based guidelines.
Certification process
On-site certification reviews are conducted by reviewers with expertise in stroke care. The certification decision is based on the evaluation of standards, clinical practice guidelines and performance measurement activities.
Primary Stroke Centers that successfully demonstrate compliance in all three areas are awarded certification for a one-year period. At the end of the first year, the organization is required to attest to its continued compliance with standards and evidence of performance measurement and improvement activities. To maintain certification, the cycle repeats with an on-site review conducted every two years and a bi-annual submission of an acceptable assessment of compliance by the organization.
Standards
The standards are published in the Disease-Specific Care Certification Manual. They incorporate the “Recommendations for the Establishment of Primary Stroke Centers” developed by the Brain Attack Coalition. The chapters address:
- Program management
- Delivering or facilitating clinical care
- Supporting self-management
- Clinical information management
- Performance improvement and measurement
Performance measurement
Effective January 1, 2010, certified primary stroke centers must collect and report on eight National Inpatient Hospital Quality Measures for stroke. Data are submitted quarterly to The Joint Commission through the secure extranet site no later than 45 days following the end of the calendar quarter. The measures include:
- Venous thromboembolism (VTE) prophylaxis
- Discharged on antithrombotic therapy
- Anticoagulation therapy for atrial fibrillation/flutter
- Thrombolytic therapy
- Antithrombotic therapy by end of hospital day two
- Discharged on statin medication
- Stroke education
- Assessed for rehabilitation
The eight measures have been endorsed by the National Quality Forum and approved as a core measure set for use in the Joint Commission’s ORYX program after October 1, 2009. For more information, go to the Web site.
Government recognition of Joint Commission Primary Stroke Center Certification
As of October 1, 2009, nine states currently require or recognize The Joint Commission’s Primary Stroke Center Certification for designation as a primary stroke center. These include Delaware, Florida, Georgia, Illinois, Maryland, North Dakota, Oklahoma, Rhode Island and Texas.
Legislative actions include:
- Virginia and Missouri are in the process of developing regulations for the designation of primary stroke centers.
- Indiana and South Carolina are discussing the development of a state-wide stroke response system.
- Pennsylvania introduced legislation aimed at expanding the commonwealth’s stroke program.
For more information about government recognition, contact Jen Hoppe, associate director, State Relations, (630) 792-5261.
Information available to the public
Quality Reports for Joint Commission certified Primary Stroke Centers are available on Quality Check™. In 2009, a “Certified Organizations” tab was added providing access to a list of all certified organizations as either a PDF or an Excel spreadsheet.
For more information about Primary Stroke Center certification, please visit the Web site, contact the Disease-Specific Care Certification Program, or call (630) 792-5291.