Recommendations for Establishing a Statewide System of Optimal Stroke Care
Recommendations for Establishing a Statewide System of Optimal Stroke Care (PDF, 1.8 MB)
In 2003, Assembly Bill 1220 established the California Heart Disease and Stroke Prevention and Treatment Task Force (Master Plan Task Force) and charged it with writing California’s Master Plan for Heart Disease and Stroke Prevention and Treatment (Master Plan). This effort was a public health priority, since heart disease and stroke are, respectively, the first and third leading causes of death in California. The Master Plan was adopted by the California Department of Health Services (now the California Department of Public Health) in 2007.
The Master Plan proposes regional stroke systems of care, a concept that is consistent with the advice of expert groups such as the American Heart Association/American Stroke Association (AHA/ASA), the Brain Attack Coalition (BAC) and others. The Master Plan’s proposed acute stroke system requires identification of eligible stroke patients in the field and direct transport to designated stroke centers. These stroke centers would be required to meet certain criteria before achieving designation. To provide maximum access to California residents, the designated stroke centers would form partnerships with hospitals that could not achieve stroke center status. These partnerships would be formalized by written agreements and protocols.
The Master Plan Task Force members recognized the many technical and policy issues inherent in the development of an acute stroke care system and recommended the establishment of a Stroke Systems Work Group (Stroke Work Group). In 2007, the AHA/ASA and California Heart Disease and Stroke Prevention (CHDSP) Program of the California Department of Public Health convened a Stroke Work Group composed of statewide stakeholders. This is a multidisciplinary group that includes experts in emergency medical services, emergency medicine, neurology, hospital administration, telemedicine, public health, and rural health care. The Work Group includes representation from the major public and private organizations that are active in promoting quality stroke care, including the California Conference of Local Health Officers (CCLHO); the California Hospital Association; California Emergency Nurses Association; California Chapter, American College of Emergency Physicians (CalACEP); California Emergency Medical Services Authority; Emergency Medical Services Administrators Association of California (EMSAAC); Emergency Medical Directors Association of California (EMDAC); the National Stroke Association; the Stroke Awareness Foundation; and the Western States Stroke Consortium.
As part of their effort, the Work Group developed this document, the Recommendations for Establishing a Statewide System of Optimal Stroke Care (Recommendations). The intent of these Recommendations is to develop a system of care that promotes the safe use of effective therapies for stroke and assures that all Californians, regardless of place of residence, receive the highest level of stroke care. These Recommendations are consistent with position statements offered by major stroke care advocates, including the BAC, National Institute of Neurological Disorders and Stroke (NINDS), ACEP, AHA/ASA, and the National Association of EMS Physicians.