Camden Clark Medical Camden Clark Medical CenterCenter

Barriers to StrokeBarriers to StrokeCertificationCertification

2013

Loni Collins RN, CCRN Stroke Coordinator

PurposePurpose

To provide an overview of some of To provide an overview of some of the barriers at Camden Clark Medical the barriers at Camden Clark Medical Center related to Primary Stroke Center related to Primary Stroke CertificationCertification

ObjectivesObjectives

History of St. Joseph HospitalHistory of St. Joseph Hospital History of Camden Clark Medical CenterHistory of Camden Clark Medical Center Explain MergerExplain Merger Explain Cultural Differences between Explain Cultural Differences between

CampusesCampuses Identify barriers to obtaining Stroke Identify barriers to obtaining Stroke

CertificationCertification

History of Saint Joseph HospitalHistory of Saint Joseph Hospital

1900’s a Roman Catholic Bishop founded 1900’s a Roman Catholic Bishop founded hospitalhospital

1960’s a long range plan developed1960’s a long range plan developed 1977 expanded to 216 beds1977 expanded to 216 beds 1996 Sisters of Saint Joseph & HCA1996 Sisters of Saint Joseph & HCA

had a joint venture- Sisters ended 2001.had a joint venture- Sisters ended 2001.

Saint Joseph (cont.)Saint Joseph (cont.) 2007 bought by Signature2007 bought by Signature 2011 joined WV United Health Systems to 2011 joined WV United Health Systems to

become part of Camden Clark Medical become part of Camden Clark Medical Center Saint Joseph CampusCenter Saint Joseph Campus

History of Camden Clark History of Camden Clark Memorial HospitalMemorial Hospital

1898 City Hospital with 40 beds1898 City Hospital with 40 beds 1918 Anne Camden dies & leaves 1918 Anne Camden dies & leaves

mansion to the City for use as hospitalmansion to the City for use as hospital 1920 moved to Camden Mansion1920 moved to Camden Mansion

History of Camden (cont.)History of Camden (cont.)

Subsequent donation from Dr. Clark Subsequent donation from Dr. Clark allowed a new hospital wingallowed a new hospital wing

1920 in recognition of Camden & 1920 in recognition of Camden & Clark’s gifts it was dedicated as Clark’s gifts it was dedicated as Camden-Clark Memorial HospitalCamden-Clark Memorial Hospital

Camden Clark Medical CenterCamden Clark Medical Center

2011 Camden Clark merged with 2011 Camden Clark merged with Saint Joseph’s to become Camden Saint Joseph’s to become Camden Clark Medical Center, an affiliate of Clark Medical Center, an affiliate of WV United Health Systems.WV United Health Systems.

2 Different Cultures2 Different CulturesSaint Joseph’sSaint Joseph’s

Saint Josephs hospital Saint Josephs hospital was primarily a “for was primarily a “for profit” hospitalprofit” hospital

Higher Socio-economic Higher Socio-economic clienteleclientele

Lower daily censusLower daily census

Camden ClarkCamden Clark Camden Clark hospital Camden Clark hospital

was a “not for profit” was a “not for profit” hospital hospital

Lower Socio-economic Lower Socio-economic clienteleclientele

Higher daily censusHigher daily census

2 Different Campuses2 Different CampusesSaint Joseph’sSaint Joseph’s

CT Scanner not CT Scanner not available 24/7available 24/7

No ResidentsNo Residents No Hospitalists No Hospitalists Avg ED visit Avg ED visit

40-60 pts/day40-60 pts/day Limited Tech coverageLimited Tech coverage Not trauma Not trauma

designateddesignated

MemorialMemorial CT Scanner available CT Scanner available

24/724/7 ResidentsResidents HospitalistsHospitalists Avg ED visit Avg ED visit

100-120 pts/day100-120 pts/day Tech coverage 24/7Tech coverage 24/7 Designated Level 3 Designated Level 3

Trauma CenterTrauma Center

Primary Stroke CenterPrimary Stroke Center

Organizationally, the decision was Organizationally, the decision was made to designate the Memorial made to designate the Memorial Campus to be the Disease Specific Campus to be the Disease Specific designated Primary Stroke Centerdesignated Primary Stroke Center

General BarriersGeneral Barriers

Difference in level of care between Difference in level of care between the 2 campusesthe 2 campuses

Assuring appropriate care for the Assuring appropriate care for the stroke patient on St. Joseph’s stroke patient on St. Joseph’s campuscampus

Ongoing state of change in Ongoing state of change in organization encompassing many organization encompassing many service linesservice lines

Specific BarriersSpecific Barriers

Building a case for the Stroke Building a case for the Stroke Coordinator PositionCoordinator Position

Physician Engagement Physician Engagement

(Locums)(Locums) Pushing the changes through to the Pushing the changes through to the

Emergency DepartmentEmergency Department Establishing appropriate policy for 2 Establishing appropriate policy for 2

different campuses with 2 different different campuses with 2 different proceduresprocedures

Specific Barriers (cont.)Specific Barriers (cont.) Extensive educational needsExtensive educational needs Encouraging patients to choose Memorial Encouraging patients to choose Memorial

Campus without compromising EMTALACampus without compromising EMTALA Ongoing challenges with house wide EMR Ongoing challenges with house wide EMR

specific to building reports and specific to building reports and documentation toolsdocumentation tools

Limited Experience with Joint Commission Limited Experience with Joint Commission Process related to Disease Specific Process related to Disease Specific CertificationCertification

Where We Are….Where We Are….

Full time Stroke Coordinator in placeFull time Stroke Coordinator in place Core Stroke Team of 3 members Core Stroke Team of 3 members

establishedestablished Stroke Council of 21 members Stroke Council of 21 members

establishedestablished Stroke alert policy, Stroke Alert Stroke alert policy, Stroke Alert

Algorithm both approved for useAlgorithm both approved for use

Where We Are…(cont.)Where We Are…(cont.)

Education in progressEducation in progress Established a time line goal for Established a time line goal for

application of Stroke Certification in application of Stroke Certification in March 2014March 2014

Questions?Questions?

Any questions, comments or Any questions, comments or suggestions?suggestions?