New scientific statement proposes ideal foundational requirements for stroke centers

Reviewed by Emily Henderson, B.Sc.Feb 7 2023

A new American Heart Association scientific statement provides guidance on staffing, leadership and resource requirements for hospital stroke centers to reduce variability and improve quality of care at stroke centers across the U.S. The new statement is published today in the American Heart Association's peer-reviewed journal, Stroke, and will be presented at 2:00 p.m. CT tomorrow, Wednesday, Feb. 8, 2023, in an Invited Symposium Session, "Cerebrovascular Nursing," at the International Stroke Conference 2023 in Dallas.

Stroke centers are certified by several different agencies at four levels: acute stroke–ready hospitals, primary stroke centers (PSCs), thrombectomy-capable stroke centers (TSCs) and comprehensive stroke centers (CSCs). Since certification began in the U.S. in 2003, there have been considerable advancements in diagnostic, prevention and treatment strategies that have increased demand for stroke center recognition via certification.

While certification requirements and some state agencies provide general standards and designate scope of practice dependent on the level of stroke services, there is a lack of detail regarding important structural components for stroke centers. Differences in these areas mean that stroke centers credentialed at the same level may function very differently.

The statement should be viewed as a call to action that proposes ideal foundational requirements for stroke centers that may help minimize inconsistencies and improve the services provided by certified stroke centers at all levels. These include suggestions for stroke program leadership, personnel resources, neuroimaging capabilities, procedural capabilities, hospital bed resources, quality improvement and clinical research, and stroke system accountability. Guidance is based on the level of certification. For example, while performance improvement plans are suggested for all four levels of stroke centers, clinical stroke research is recommended as a foundational requirement only for TSCs and CSCs. Also, a dedicated stroke unit is required for all but the acute-stroke ready level of certification, and a neurocritical care unit is required for a comprehensive stroke center.

This scientific statement, "Ideal Foundational Requirements for Stroke Program Development and Growth," was prepared by the volunteer writing group on behalf of the American Heart Association's Council on Cardiovascular and Stroke Nursing and the Stroke Council. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association's official clinical practice recommendations.