Coalition Updates Recommendations on Standards for Primary Stroke Centers

Abstract

THE PAST DECADE’S ADVANCES IN the diagnosis and treatment of patients with stroke have led the Brain Attack Coalition to revise and update its recommendations for the establishment of primary stroke centers. The coalition first proposed primary stroke centers in 2000 as a means of improving patient care and outcomes, with the possible added benefit of reducing medical costs associated with the condition. Each year, almost 800 000 people in the United States have a new or recurrent stroke, resulting in annual costs exceeding $73 billion. Formed in 1994, the Brain Attack Coalition is a group of professional, voluntary, and government entities promoting relationships among its member organizations to reduce stroke risk and improve stroke care (http://www .stroke-site.org/). Members of the coalition include the American Academy of Neurology, the American College of Emergency Physicians, the American Stroke Association, the National Institute of Neurological Disorders and Stroke, and many others. Based on the trauma center model, primary stroke centers are intended to be the care facilities that receive most patients with suspected stroke transported by emergency medical services. The coalition’s original proposal recommended that such centers should feature acute stroke teams, dedicated stroke units, written care protocols, and an integrated emergency department and emergency medical services response (Alberts MJ et al. JAMA. 2000; 283[23]:3102-3109). The primary stroke center concept was soon implemented in various care facilities. The primary stroke center health care team stabilizes and provides emergency care for patients with acute