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Recertification of Stroke Centers in Latin America WSO/SIECV
At the conclusion of 2 (two) years since the Certification of the Center of WSO/SIECV Program, we hope that throughout this time the quality of care based on the best available evidence and continuous improvement have been the constant during daily clinical practice. The Centers must continue to meet 100% of the mandatory criteria and at least 85% of the recommended criteria to apply for recertification.
Recertification Steps:
- Fill out the application form for Recertification available in the Center's environment that is located on the program's platform by entering your username and password.
- Once the form is filled out and you are eligible for Recertification (the system will inform you of its status and results), you will be able to attach the corresponding documentation, which is described below. You must fill out the document "Register of Quality Indicators" with the data corresponding to the two immediately preceding years (they must be filled out separately, with the data for each year).
- Attach the necessary information to verify the implementation of strategies to comply with the suggestions and indications given during the initial certification process (contemplated in the "Visit Report" document) sent to each center.
- The documents submitted and the quality indicators will be presented during a meeting of the Evaluation Committee, who will define if the center is suitable to be Recertified or if it is necessary to attach additional information. Likewise, the Committee will decide the need to conduct a new visit or whether recertification can be granted based on the information provided and the findings of the first visit.
· Centers must have 100% of the mandatory criteria and 85% of the recommended criteria (to know their current status, please use the Self-Assessment tool).
· Update of Certificates (NIHSS and modified Rankin scales).
· Update of training for the care team in general.
· Update of the Care Protocol.
· Up-to-date registration in one of the international or national platforms recognized for the registration of quality indicators (RES-Q, SITS, NORA Registry, National Registry). Local own registrations will not be accepted.
· In case of changes in the infrastructure and/or material, human and documentary resources, this documentation must be attached.
· Advanced Centers must have a geographically defined area (exclusive or mixed) for the care of patients with stroke (Stroke Unit).
· Evaluate the suggestions and indications reported in the “Visit Report” document and provide support for the strategies implemented to solve the difficulties identified during the certification process.
· Finally, centers that have been certified as Essential and have the necessary resources to apply as Advanced, will be able to start the process at any time they wish.
The centers must have the certifications and up-to-date training of all the professionals involved in the care of patients with Cerebrovascular Attack, maintaining the same demands and intensity of the initial certification process:
Neurologists: Certified in NIHSS and modified Rankin scale valid for no less than 2 years.
Nurse Leader for each area of care: Certified in NIHSS valid for no less than 2 years.
Professional in charge of recording quality indicators: Certificate in modified Rankin scale valid for no more than 2 years.
Emergency Nursing Staff: Training in the role of nursing in the care of patients with stroke in its hyperacute and acute phases (hourly intensity of no less than 2 hours/year).
Nursing staff in general (Stroke Unit, Intensive / Intermediate Care Unit, general hospitalization): Training in the care of hospitalized patients with stroke (hourly intensity of no less than 4h/year).
Suggested topics: Rating scales (NIHSS, mRankin, BARTHEL, etc.), swallowing, and nutrition, temperature and vital signs control, glycemic control, mobilization, secondary prevention, anticoagulation protocol, physiological eliminations, etc.
Emergency Physicians: Training in the care of patients with stroke (hourly intensity of no less than 4 hours/year).
Suggested topics: Early and timely recognition of the patient with stroke, Activation of the stroke code, Care protocol, Acute assessment scales (NIHSS and modified Rankin), Neuroimaging protocol and interpretation, care pathway, intravenous thrombolysis, mechanical thrombectomy, pre, intra and post thrombolysis care, dysphagia evaluation, etc.
Doctors of the Stroke Unit, Angiosuite, Intensive or Intermediate Unit: Training in the care of patients with stroke (hourly intensity of no less than 8 hours/year).
Suggested topics: Early and timely recognition of stroke patients, Stroke code activation, Care protocol, Neuroimaging protocol and interpretation, care pathway, intravenous thrombolysis, mechanical thrombectomy, pre, intra and post thrombolysis care, secondary prevention of ischemic stroke, blood pressure management in patients with cerebrovascular disease, etiological investigation, timely rehabilitation, among others.
Physiotherapy, Occupational Therapy and Rehabilitation in general: Training in the care of patients with stroke (hourly intensity of no less than 4 hours/year).
Suggested topics: Rehabilitation protocol for patients with cerebrovascular disease, evaluation scales, rehabilitation planning, among others.
Centers that have modified the Acute Care Protocol or updated their clinical practice guidelines must attach the new document.
Up-to-date general care protocols.
In the event of changes in infrastructure and material, human and documentary resources, these must be annexed.
Strategies to continuously improve the quality of care.
List of attendances to periodic meetings of the Stroke program.
In addition to the mandatory requirements that are available in the registration form, the following recommendations will be taken into account:
The Certified Center must have updated the register of quality indicators on an external platform (RES-Q, SITS, NORA registry, Recognized National Registry), regardless of the certification category.
Advanced Centers must have a geographically defined area (exclusive or not) for the care of patients with acute stroke (Stroke Unit).
The Center must have a Lead Neurologist for the care of patients with cerebrovascular disease.
Demonstrate implemented strategies and data demonstrating improvement in the number of patients undergoing acute reperfusion therapies (thrombolysis or mechanical thrombectomy) for those Essential and Advanced centers that did not meet the minimum number of suggested annual cases.
Centers that do not comply with the minimum number of thrombolysis must demonstrate with greater veracity and compliance the organization of the service and that all eligible patients are being treated, corroborating that the low number of thrombolysis and/or thrombectomy is due to reasons over which the center has no influence.
The Advanced Center must have the availability of the Neurology service in full time (face-to-face or remotely) for decision-making in the hyperacute phase of the stroke patient.
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