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General Concepts: Stroke Systems of Care

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Ischemic Stroke Therapeutics

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Abstract

The continuum of stroke care begins with the onset of symptoms and recognition in the field, to the discharge of the patient into the community. The ideal care of the stroke patient as he or she moves through this continuum includes coordination of systems that are designed to provide care at each step, including multiple disciplines, providers, and settings. Systems of care have been developed for the pre-hospital and inpatient portion of the continuum, but post-acute care for stroke patients is still very fragmented. The purpose of this chapter is to provide an overview of the evidence supporting the use of systems of care, and to identify the existing gaps where evidence, guidelines, and ultimately policies are needed.

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Abbreviations

EMS:

Emergency medical services

CMS:

Centers for Medicare and Medicaid Services

AHA:

American Heart Association

GWTG-Stroke:

Get With The Guidelines-Stroke

tPA:

Tissue plasminogen activator

DTN:

Door to needle

ESD:

Early supported discharge

IRF:

Inpatient rehabilitation facility

SNF:

Skilled nursing facility

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Authors and Affiliations

  1. Department of Neurology, Wake Forest University Baptist Medical Center, Medical Center Boulevard, 6th Floor Janeway Tower, Winston-Salem, NC, 27157, USA

    Amy K. Guzik M.D. & Cheryl D. Bushnell M.D., M.H.S.

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  1. Amy K. Guzik M.D.
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  2. Cheryl D. Bushnell M.D., M.H.S.
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Correspondence to Amy K. Guzik M.D. .

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Editors and Affiliations

  1. Admiral Pihl Professor and Chairman of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA

    Bruce Ovbiagele

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Guzik, A.K., Bushnell, C.D. (2016). General Concepts: Stroke Systems of Care. In: Ovbiagele, B. (eds) Ischemic Stroke Therapeutics. Springer, Cham. https://doi.org/10.1007/978-3-319-17750-2_27

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  • DOI: https://doi.org/10.1007/978-3-319-17750-2_27

  • Publisher Name: Springer, Cham

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