Coverdell Partners:
Georgia Department of Public Health (DPH)
Emory University School of Medicine
Georgia Medical Care Foundation (GMCF)
American Stroke Association (ASA)
Georgia Hospital Association (GHA)
If you have anything you would like included in an
upcoming newsletter or have
achieved recent recognition in the
area of stroke, contact:
Kerrie Krompf
kkrompf@emory.edu
or
404-616-8741
Georgia Coverdell Acute Stroke
Registry Quarterly Newsletter
SUMMER 2011
Recognition of Coverdell Hospital Stroke Month Activities - May 2011
Atlanta Medical Center (AMC)
Atlanta Medical Center geared up for the May Stroke Month activities by providing stroke education and prevention strategies to four local Senior Citizen Centers as part of their Healthy Living Series. Community outreach continued with Dr. Mishu, the Stroke Medical Director, and an AMC stroke survivor sharing the stroke journey with the staff at the Georgia Department of Community Health. Another outreach was providing a national group of Human Resource manager's stroke prevention initiatives to support their employees in healthy outcomes. An exciting opportunity was participating in career day at a local elementary school. The students were taught how to identify a stroke by using FAST and the importance of stroke prevention.
The Emergency Department provided an EMS appreciation cookout which featured updated information for pre-hospital stroke management. There were two stroke lunch and learns provided for the medical staff, nurses, and therapists; one related to an update on antiplatelet therapy and the other on the clinical consequences of Afib. The monthly ASLS class continues to support stroke education to the staff at AMC. The May ASLS class was exceptional because for the first time there were six therapists participating in the class reinforcing their importance as partners on the stroke team. The highlight for the Stroke Month activities was the Steps for Stroke Scrub walk/run that provided education and activities for the entire family.
There were several health fair events at churches and community associations that staff members participated in. FAST cards and the AHA/ASA Soul Food recipe cookbooks were shared at many of the events listed above along with a Stroke Risk Assessment tool and a plan on how to modify risk factors. It was an extremely busy month but it doesn't stop here, education and outreach continues every day.
Floyd Medical Center (FMC)
Floyd Medical Center started Stroke Month with a mock "Stroke Alert" at Wal-Mart. Some of the stroke team members and EMS met with the manager at Wal-Mart to arrange an "event" at 6:00pm in the front of the store. A stroke team member mimicked a stroke with signs and symptoms of left-sided weakness and aphasia as another FMC employee witnessed the event and called 911. EMS came in with the stretcher and did the Cincinnati Stroke scale. There was a group of curious onlookers as EMS loaded the "Patient" and left with sirens blaring. The Director of Neuroscience spoke to the reporter regarding the purpose of the event and the reason 911 was so important. The next morning FMC staff attended Wal-mart's staff meeting and spoke about risk factors and the importance of blood pressure control and diet.
In addition, FMC had two radio speeches about Stroke Month. The Stroke Team partnered with EMS and visited 5 Senior Citizen Centers to do Stroke lectures and offer Stroke screenings.
Dr. David Hale, Neurologist at the Harbin Clinic, gave his time to talk with the Critical Care Class regarding Stroke and the importance of early treatment as well as new procedures and treatments in the future for Stroke.
To end Stroke Month, EMS hosted a luncheon for their employees and Dr. Hale talked about treating Stroke in the field. The FMC Stroke Team, which recently won the Gold Plus Award from the American Heart Association/American Stroke Association, reached approximately 300 people during the month of May.
FMC is very active in the community with Stroke Education and they do lectures and Stroke screenings throughout the year.
Medical Center of Central Georgia (MCCG)
The Medical Center of Central Georgia, a part of Central Georgia Health System, is the second-largest hospital in Georgia and the only designated Level I Trauma Center in the region. MCCG delivers world class diagnostics and wellness, emergency, heart, cancer, ortho, stroke and specialized surgery to a service area of 28 counties surrounding Macon and Bibb County.
The month of May was National Stroke Awareness month and MCCG focused on many initiatives that were targeted to provide education to the community on stroke awareness and prevention. These events were scheduled throughout the month of May. MCCG's mission for this year's stoke month was to "Hit the Streets" and reach at least 5000 non-employees to provide stroke education on awareness and prevention. They sought to arm the community with the knowledge of signs and symptoms of a stroke in order to encourage early treatment.
On May 5th, the Mayor's Office presented MCCG with a proclamation at City Hall declaring May Stroke Month in Macon. Afterwards, employees and friends of MCCG "Hit the Streets" to distribute posters and magnets to local businesses and schools throughout the Middle Georgia area. On May 10th, Central Georgia Rehabilitation Hospital hosted Media Day, in which the community was able to witness and experience the simulation of how victims of stroke are actually affected. On May 18th, MCCG sponsored its 5th annual Stroke Symposium with attendees coming from all over the state of Georgia. The key note speaker was Dr. Raul Nogueria, MD--Director of the Neuroendovascular Center at the Marcus Stroke and Neuroscience Center at Grady Memorial Hospital. On Saturday, May 21st, MCCG participated in a community fair hosted by J.H.Walker Lodge #55, P.H.A. at L.H.Williams Elementary School. During the community fair, stroke education and material was provided to individuals and free blood pressure checks were done. Stroke Month concluded with an Executive Luncheon held for local stakeholders at the Macon Marriot Center.
Stroke Month for MCCG was very successful and could not have taken place without the hard work, dedication, and commitment of MCCG employees, partners, family, friends, and most important of all, the patients they serve.
Medical College of Georgia (MCG Health)
During the month of May, MCGHealth held a variety of educational opportunities around the facility. Every Monday was dedicated to hospital-wide lunch education. They provided an educational table with take-away stroke education that reached staff, students and visitors. Every Thursday they held stroke risk screenings in their patient resource library. This was a time where hospital staff and visitors could come in and sit down with neuroscience nursing staff and have their blood pressure checked and a discussion regarding their personal risk factors. Several of the employees were directed to their doctors to receive medication for blood pressure and several members of the neuro nursing team agreed to hold them accountable. They held several classes in their resource library on stroke to educate the general public. MCGHealth has a daily publication "The daily update" that is read by all employees. Everyday in the month of May they had a different stroke fact for the day listed with a link to the neuroscience website where a full calendar of events could be obtained. They held inservices for other departments in the hospital. They did several days of inservices for their women's health floors and reminded the nurses about stroke and pregnancy, stroke postpartum, and how to properly educate new mom's going home with high blood pressure about their risk later in life for stroke. MCGHealth also had a pediatric stroke poster made especially for the pediatric resource library that was displayed during the month of May. Dr. Jeffery Switzer gave two lectures to EMS during May regarding stroke and pre-hospital stroke care.
Memorial Hospital
Memorial Health had a very BUSY May. They teamed up with local news media, radio stations, digital billboards, and print ad in the hopes of educating the public on the signs and symptoms of stroke as well as the importance of early treatment. Their physician leaders participated in multiple speaking engagements in the region. They dedicated the third week of May as Memorial Stroke Week by offering daily stroke specific educational inservices to staff and collaborated with local EMS to show their appreciation by sponsoring three events during national EMS Appreciation Week.
Piedmont Hospital
Piedmont Hospital had a busy stroke month with two community health screenings and numerous staff in-services that went towards the required Joint Commission education for staff. Community education/in-services were also provided throughout the month at a local fitness center, providing attendees with magnets listing the signs and symptoms of stroke and brochures with risk factors and general stroke education. They put outdoor banners up on Peachtree and Collier Roads with F.A.S.T. information. Stroke education table tents were placed in the cafeteria and food court tables where staff and community members ate. Stroke committee members received gifts in appreciation for their continued work. An exciting in house stroke awareness day occurred with a healthy cooking demonstration and information table with stroke related give aways, accessed by both hospital staff and community members.
Saint Joseph's Hospital of Atlanta
Members from the stroke advisory committee (Cheryl Bittel, MSN, RN, Saba Gidey PharmD, Sr. Peggy Fannon, RN) presented information during lunch and learn sessions which took place each week in May. Session topics included t-PA administration, anticoagulation/anti-platelet use in the ischemic stroke patient, lipids and stroke disease, and diabetes management.
Dr. Keith Sanders, Dr. Omar Jalil, Saba Gidey PharmD, and Dee Lacey, MSN, RN led a stroke talk during the last week of May. The presenters provided information about the following:
TIA and Stroke Overview Management of Blood Pressure after an Acute Stroke Pharmaceutical Management Post TIA/Stroke Stroke Alert Process at Saint Joseph's Hospital Atlanta
In an effort to provide additional education to employees and visitors, the stroke advisory committee created a bulletin board display outside of the cafeteria which provided information about stroke risk factors, signs and symptoms of stroke, and a display to illustrate how strokes in different parts of the brain affect the body. The bulletin board also highlighted the members of the stroke advisory committee and displayed their American Heart Association/American Stroke Association Gold Plus award. In addition, "The Power to End Stroke" materials (cookbooks, risk factor assessments, pens, FAST cards, meal plans) were distributed to employees and visitors in the cafeteria. Saint Joseph's Hospital of Atlanta had a great stroke awareness month!
Southern Regional Medical Center
Kim Anda RN, Stroke Manager. gave a stroke prevention presentation to 5 senior groups in Clayton and Fayette counties. Kim and Jane Johnson, RN, Stroke Data Coordinator, participated in an employee health fair and provided stroke education, blood pressure screening and stroke risk assessments for employees that stopped by their table. With the help and support of the marketing department they made a teaching DVD for pre-hospital stroke care for EMS and provided a grab and go luncheon outside the Emergency Department. Any EMS provider who stopped at the tent outside the ED enjoyed a boxed lunch and received an Educational DVD and pen light. They had picnic tables and the stroke team had lunch and talked with paramedics and EMT's about a variety of stroke topics. Southern Regional also had a banner hung in the hospital lobby announcing stroke awareness month. Additionally, they put a bulletin board in the ED with educational materials for Target Stroke, focusing on strategies for improving DTN's and announcing an incentive program for ED Nurses achieving DTN's in under 60 minutes. It was a busy month for the stroke team at Southern Regional.
Spalding Regional Medical Center
On May 26th, Spalding Regional Medical Center hosted over 60 attendees in their surrounding communities to a day devoted to "Save Your Brain". Catherine Whitworth of Williamson - RN, Quality Analyst and Stroke Coordinator for the hospital invited all the Spalding and Pike County neighbors to come and learn to protect themselves. Whitworth said, "Too many people don't understand the signs and symptoms of stroke the way they do a heart attack. Stroke is a brain attack, and an emergency. However, it can be treated successfully to lessen the effects, but it must be treated quickly."
Spalding Regional held the free "Stroke Awareness and Prevention" event at the hospital in Griffin. In addition to individual screenings including blood pressure, cholesterol and glucose and body fat analysis, the hospital also offered education stations available to discuss the signs and symptoms of stroke, Atrial Fibrillation and Transient Ischemic Attack (TIA).
Other educational opportunities at the event included learning which risk factors are preventable and which can be controlled, Spalding Regional's Center for Sleep Medicine discussed how sleep habits may increase your risk of stroke; and a consultation station staffed with RNs discussed personal risks. Spalding Regional's Center for Rehabilitation had therapists on hand to discuss rehab options following a stroke, including physical, occupational and speech therapies.
Wellstar Cobb
"Know Stroke: act F.A.S.T." is the running theme for the community outreach education at WellStar Cobb Hospital in Austell, Georgia. During Stroke Awareness Month this May they put their mantra to work. They started with a community fair hosted by the Douglas County Chamber of Commerce and held it at Arbor Place Mall all day one Saturday. The Stroke Team partnered with the corporate office and offered B/P, and lab screenings as well as nutritional consults. Members of the nursing team handed out stroke risk scorecards and elaborated to over 200 people what "act F.A.S.T." means. If there was a long wait, no problem, people enjoyed a free chair massage compliments of the stroke rehab staff. They
then shifted attention to the city of Marietta and once again partnered with their corporate offices and continued the theme of "act F.A.S.T." to Lockheed during their employee health fair. They continued education with their own hospital staff -- for the non-clinical staff they handed out "Act F.A.S.T." cards compliments of the Genentech representative and had some fun with a cartoon video about stroke recognition. The critical care and stroke unit nurses brushed up on their knowledge of anticoagulants and enjoyed a sumptuous lunch compliments of Sanofi-aventi while the newest members of the team attended Stroke School. Throughout the hospital and on every cafeteria table they placed tent cards explaining with the aid of pictures how to "act F.A.S.T." Along the wall to the hospital main entrance, the creative members of the stroke team put together a 4 foot high and 10 foot long pictorial display of, you guessed it, "Know Stroke: act F.A.S.T." Two employee information boards were displayed -- one showing the Stroke LEAN projects undertaken this past year and one by the Radiology Department. The culmination of the events was a celebration breakfast with all departments involved with the stroke program in attendance. During this meeting Kim Nichols from the American Heart Association/American Stroke Association presented to our Stroke Medical Director Dr. M. Rachelefsky, a GWTG Bronze award for achievement in performance improvement. Dr. Rachelefsky then presented the award to Cerise Wotorson, manager of the Cobb Hospital stroke unit, along with members of the stroke unit team. The capstone of the gathering was a 32 page "data picture" of the stroke program at Cobb Hospital from its beginning in 2008.
West Georgia Health System (WGH)
The Stroke Prevention team at West Georgia Health (WGH) in LaGrange, Ga., a 276-bed community hospital, believes that prevention education begins at home. That's why the team's first event in May during National Stroke Awareness Month was a lunch and learn opportunity aimed at WGH's 1,400 employees. Team members set up an informative display for staff outside the cafeteria that included free cookbooks with healthy eating tips, brochures outlining stroke prevention and a display showing the warning signs and symptoms of stroke.
Following an internal campaign, the team began spreading the message out in the community. LaGrange was the site of the Bassmaster Elite Series Pride of Georgia fishing tournament May 5-8. The Top 99 professional anglers in the world came to West Point Lake to compete for $100,000 in prize money. The Stroke Team came up with a creative way to participate in the event and present their prevention message to spectators. They handed out 1,700 bottles of water (72 cases) with a custom label listing the warning signs and symptoms of stroke on the bottles. The prevention effort was mentioned in a front page story in the LaGrange Daily News.
The team followed that up with an appearance on a local TV program, City Week. Twyla Buttrill, RN, quality initiatives coordinator, and Joy Brooks, RN, director, Progressive Care Unit and Telemetry manager discussed risk factors for stroke and the types of medical treatment available through WGH's telestroke program with the Medical College of Georgia, which provides remote access to neurological services when local coverage is unavailable.
Although most people think of stroke as affecting only adults, the Stroke Team is aware that younger people can also be at risk. Team members were on hand to make teens aware during the annual community-wide athletic physical event conducted by local physicians and nurses for student athletes who attend Callaway, LaGrange and Troup high schools at West Georgia Technical College. Team members handed out fliers to more than 600 students with information about the risk factors and symptoms associated with teens.
The month ended with Memorial Day festivities at the annual Superstar Football Camp for youngsters held at the local high school football field, Callaway Stadium. Parents and grandparents of attendees were offered free health screenings and information about stroke prevention and awareness. Twyla Buttrill, RN, quality initiatives coordinator and Joan Howard, RN, Manager, Emergency Department, discussed the warning signs and symptoms of stroke and handed out brochures with stroke prevention information to attendees.
WGH Nurses Tara McKeen and Clarissa Grizzard hand out free bottled water with a stroke prevention message to spectators
at the Pride of Georgia fishing tournament held at West Point Lake in May in LaGrange.
Twyla Butill, quality initiatives coordinator sets up a display with the warning signs and symptoms of stroke at the annual Superstar
Football Camp for youngsters held at the local high school in LaGrange, GA.
A Mother's Day Magnet Moment
from Rex Milner, RN, Nursing Supervisor
Mother's Day 2011-St. Francis Hospital A patient on the 4th Floor was visiting her daughter and granddaughter in the front lobby of our hospital on Mother's Day. Her daughter noticed that her face was drooping, and she was having trouble speaking and understanding. Her daughter thought her mother was exhibiting symptoms of a possible stroke. Her daughter reacted immediately and called for a Rapid Response Team (RRT). In less than 15 minutes the Rapid Response Team sent the patient to CT, within 45 minutes of the call, the patient was sent to Critical Care and tPA was started. In less than 2 hours the tPA was complete and the patient was totally resolved of all stroke symptoms and was moving all extremities. Every minute counted for this stroke patient and acting fast lead to the patient getting the stroke treatment she desperately needed. The hospital heroes who responded to the call were Dr. Kevin King, Hospitalist; Tracey Mapp, RN; Ryan Kuyers, RN; Nikita Jones, RN; Rashonda Ali, RN and Heather Bolden, RN. These staff members responded quickly and were able to reverse the effects of the stroke. This Stroke Alert, lead by the RRT, was a huge success story and a memorable Mother's Day Moment for the patient, her family and the heroes.
Stroke Survivor Takes Next Step for St. Mary's
At age 30, Oconee High School English teacher Sally Baker worried about stroke for her grandparents, not herself. But after developing life-threatening preeclampsia and suffering the loss of her baby at about 20 weeks gestation, Sally developed signs of stroke while recovering from liver infarction.
The staff at St. Mary's Family Birth Center rushed her into the hospital's stroke care system, the only program in the Athens area to receive the American Heart Association/American Stroke Association Gold Plus performance award for stroke care. Within minutes, Sally was diagnosed with a hemorrhagic stroke and admitted to St. Mary's Neuroscience Critical Care Unit.
She woke up unable to move the right side of her body, squeeze her hand, speak, or even grunt. She also woke up to her neurosurgeon, Kimberly Walpert, MD, standing at her side.
"She told me, `Sally, you've had a stroke, but you are going to recover fully.'," Sally says. "Today we call it `Walpert's Law' whatever Dr. Walpert says, goes. I had no choice but to do as she said and recover."
She smiles as she says this, and then notes that her smile was always a little crooked before her stroke. Today it's perfect, thanks to her own hard work and the skill of her rehabilitation team at St. Mary's.
Sally quickly progressed through St. Mary's NCCU and general neuroscience nursing unit, then went to St. Mary's Center for Rehabilitative Medicine. For two weeks she received three hours of intensive physical and occupational therapy and speech-language pathology every day.
"It was not always easy to go to the rehab center cafeteria and face other people," she admits. "I had to tell my story and my story was hard. But by sharing my story I felt like I was winning over the stroke and over all the bad things that had happened to me."
Sally bonded with the staff as they led her step-by-step toward recovery. "I started with standing, then walking, then taking the stairs. They would not let my husband do something like tie my shoes for me when I could do it myself. I earned my independence back."
After Sally went home she began working with therapists at St. Mary's Outpatient Rehabilitation Center, setting and then meeting increasingly ambitious goals, including walking across the stage at graduation in May and returning to teaching in August 2010.
That fall she set her next goal: walking a 5-kilometer event in the spring. But her friends challenged her to go one step further: to create a 5K event that would raise both awareness of stroke and funds for the St. Mary's program that was helping her get her life back.
And so she did. On April 2, 2011, the one-year anniversary of her stroke, Sally and her husband, Brad, led more than 150 people on the inaugural Next Step 5K at Oconee County High School. In addition to raising thousands of dollars for St. Mary's stroke program, the event gave Sally an opportunity to dramatically raise stroke awareness across North Georgia, including feature profiles on WAGA-Fox5 Atlanta and multiple articles in area newspapers, including the Athens Banner-Herald, the Oconee Enterprise and the Oconee Leader.
Sally and St. Mary's Foundation have already started planning next year's event, and Sally, who completed her 5K walk with flying colors, has set a new personal goal for her 2012 event: "Next year, I'm going to run it."
Pictured right: Stroke survivor, Sally Baker
Plain to See: Areas with High Stroke Death Rates and Poor Access to Stroke Care Highlighted in New Stroke Belt Study
Epidemiologists from Georgia, North Carolina, South Carolina, and the CDC recently published a journal article entitled "Geographic and socio-demographic disparities in drive times to Joint Commissioncertified primary stroke centers in North Carolina, South Carolina, and Georgia." The article's maps display counties in the tri-state area with high stroke death rates and poor access to acute stroke care. Using mapping software, researchers analyzed 30 and 60 minute drive-times to Joint Commission-certified primary stroke centers, Paul Coverdell National Acute Stroke Registry hospitals, and Get With the Guidelines-Stroke hospitals. Significant disparities were found in the populations within the drive time areas, and many counties with high stroke death rates were outside the drive time areas. The authors hope the findings will be useful in enhancing stroke systems of care in these states and in resource allocation, particularly for underserved populations. Both the former and acting Principal Investigators of the Georgia Coverdell Acute Stroke Registry, Laura Fehrs and Lydia Clarkson, respectively, are co-authors on the paper. This work would not have been possible without the generous help of our partner Mary Robichaux from the Southeast Affiliate of the American Heart Association.
The full article with detailed results and color maps is available for free at: www.cdc.gov/pcd/issues/2011/jul/10_0178.htm
Georgia Stroke Professional Alliance (GA-SPA)
The next Georgia Stroke Professional Alliance (GA-SPA) meeting will be held on Wednesday, August 17th from 10 am to 3 pm at the Medical Center of Central Georgia, Macon, in the West Tower Trice Room 8. The guest speakers will be Cathleen Sass, PharmD, MBA who will present on: Atrial Fibrillation: An Escalating CVD with Significant Clinical and Economic Consequences and Nojan Valadi MD, presenting on "Pradaxa and Stroke". Election results will be announced at the August 17th meeting. If you haven't voted and are a member of the GA SPA, go to: http://www.surveymonkey.com/s/LVL7MXG . Voting ends on Monday, August 8th.
We are proud to say that to date, the GA SPA has over 200 members. If you would like to attend the August 17th meeting or for more information about the GA SPA contact Kerrie Krompf at kkrompf@emory.edu.
Coverdell Highlights
June Conference Call
Northeast Georgia Medical Center(NEGA) has recently changed from a Joint Commission accredited hospital to a DNV accredited hospital and we would like to thank Trish Westbrook, Nurse Practitioner/Stroke Coordinator, from NEGA for giving us a brief presentation on her hospitals recent DNV Certification. In addition, we would like to thank Mary Robichaux, VP of Quality Improvement Initiative for the greater SE affiliate of the AHA, for updating us on the Coverdell Murphy Act.
July Conference Call
Our guest speakers on the July Coverdell conference call were James Lugtu, Manager and Stroke Program Coordinator of Columbus Regional's Brain and Spine Center, and Jody Mitchell, EMT with Mid Georgia Ambulance Service. James and Jody spoke about giving patient feedback from both the EMS perspective and the stroke program perspective as well as the importance of working together to improve patient care. Thank you to both James and Jody for sharing this important information with us.
August Conference Call
Thanks to Michael Frankel MD, Lead Neurologist for the Georgia Coverdell Acute Stroke Registry, on updating the Georgia Coverdell hospitals on where we stand with door to needle time. Door to needle time has been the performance measure focus of the GA Coverdell Acute Stroke Registry beginning in January 2011. We would also like to thank Lydia Clarkson MPH, Interim Principle Investigator of the Georgia Coverdell Acute Stroke Registry, for presenting on the drive time article which was recently published. More information on the article is discussed on the previous page.
If you have not received any of the presentations and would like one, e mail Kerrie Krompf at: kkrompf@emory.edu.