South Florida Partnership Introduces EMS-Driven Initiative to Expedite Triage for Stroke Treatment

July 24, 2019—At the Society of NeuroInterventional Surgery’s (SNIS) 16th annual meeting held July 22–25 in Miami Beach, Florida, investigators presented a progressive emergency medical services (EMS)–driven partnership in South Florida that has expedited access to lifesaving care for stroke patients.

The South Florida Stroke Coalition established a regional quality assurance dashboard in coordination with regional EMS agencies and neurointerventionalists collaborating with the University of Miami’s Florida Stroke Registry team. The novel dashboard enables area hospitals to share quality metrics and outcomes with EMS medical directors about time-sensitive treatments administered to acute stroke patients.

According to SNIS, the dashboard helps EMS medical directors identify the most appropriate hospital destinations for a given stroke patient with the goal of directly transporting the patient to the center that can provide appropriate treatment right away, even if it means having to bypass other facilities to do so.

Part of a statewide effort to improve outcomes, the initiative aimed to optimize both prehospital (EMS) and in-hospital processes. A core tenet of the South Florida Stroke Coalition was that stroke centers could no longer simply provide thrombectomy through self-attestation; instead, they needed to apply for Joint Commission certification to verify their capabilities and performance.

Brijesh P. Mehta, MD, is a neurointerventional surgeon at the Memorial Neuroscience Institute in Hollywood, Florida, and a lead author of the study. He commented in the SNIS press release, “Over the past decade in South Florida, there has been a proliferation of stroke centers. However, the resources and capabilities that each offer have been extremely variable. Currently, EMS transports stroke patients to the nearest hospital rather than using data to make informed triage decisions. This dashboard will be instrumental for benchmarking the quality of stroke care across the region and ushering in hospital-level accountability.”

Paul Pepe, MD, a study coauthor and Head of the United States Metropolitan EMS Medical Directors Consortium, added, “Every minute counts when brain cells are dying—the earlier the intervention, the better the results. This vanguard South Florida experience is compelling and serves as a model for progressive stroke care around the world.”

SNIS noted that in June 2019, Florida Governor Ron DeSantis signed “CS/CS/SB 1460: Stroke Centers,” a bill that will improve first responders’ identification of hospitals that can reliably provide rapid access to thrombectomy when needed. Passage of the law was bolstered by the efforts of the national SNIS Get Ahead of Stroke campaign. The law aims to reduce disability and death as a result of severe stroke; additionally, it is intended to stem the immense long-term costs for ongoing, complex health care and the unrelenting need for specialized caretakers to support daily activities of living for severely disabled stroke patients.