A Comprehensive Picture of Stroke Care: The Florida Stroke Registry Annual Meeting
Each summer, Florida Stroke Registry (FSR) stakeholders, including health care providers, state representatives and personnel from stroke centers, review the state of stroke care in Florida. The theme of this year’s stakeholder meeting emphasized improving stroke care by breaking down silos.
“The Florida Stroke Registry is more than just a registry. It’s a statewide initiative that merges data to provide a comprehensive picture of stroke care in Florida,” said Jose Romano, M.D., executive director of the FSR and professor and chair of the Department of Neurology at the University of Miami Miller School of Medicine. “Our meeting brought a group of committed, passionate stakeholders together as we collaborated to improve stroke care in Florida.”
From the 2024 FSR Annual Stakeholder Meeting
State Commitment to Stroke Care
From 2012 to 2017, the FSR operated as an NIH-funded program under the direction of the late Dr. Ralph Sacco. Since 2017 it has been supported by state funding. The FSR recently received $1.5 million to enhance data infrastructure that will securely link acute stroke data from its 180 stroke hospitals with Florida administrative datasets reflecting the pre- and post-hospital phase of care.
Data linkage will enable the FSR to create reports and provide feedback to stakeholders across the system of care. The funds will also be used to increase community stroke awareness education, emphasizing identifying stroke symptoms, calling 911 immediately upon symptom onset and promoting lifestyle modifications to prevent a second stroke.
Community Stroke Engagement and Messaging
The FSR dedicated the first day of the annual meeting to community engagement, focusing on effective stroke care messaging such as the Haitian Creole translation of the BE FAST stroke awareness acronym. Another session focused on stroke risk factor management and education delivered by community health workers. Medics and stroke coordinators were offered a separate EMS workshop which reviewed the application of stroke scales, guidelines and case studies.
The inaugural Coalition of Coalitions meeting, moderated by Dr. Romano and Carolina Gutierrez, Ph.D., associate director of the FSR and research assistant professor of neurology at the Miller School, was established in response to an action Item from last year’s annual meeting and will give a platform to the seven local stroke coalitions in Florida.
“By establishing this gathering, the FSR is enabling a networking forum where FSR stakeholders participating in local stroke coalitions may learn of regional goals, gaps and best practices,” Dr. Guiterrez said. “Bringing all the stroke coalitions together not only enhances collaboration across the state but also improves generalizability of stroke care initiatives. Our united and coordinated efforts to improve the quality of stroke care for all make Florida a model across the nation. We look forward to establishing this gathering as a regular event in our annual meeting.”
Keys to Advancing Stroke Care
Four sessions on targeted implementations for hospitals served as the focal point during the meeting’s second day. Dr. Romano provided an update on the registry, followed by hospital leaders who discussed Florida’s first mobile stroke treatment unit, EMS/hospital communication platforms and the latest stroke data sets.
“Our initiative spans multidisciplinary engagement and education for health care professionals and the community,” Dr. Romano said. “By using data, we create a clear picture of stroke care in Florida. During a stroke, patients lose 1.9 million neurons per minute, so we must avoid delays in care. We identify gaps and implement solutions, particularly in areas with high health inequities.”
Cheryl Bushnell, M.D., professor of neurology at Wake Forest University, delivered the keynote address on stroke care for women. Since women live longer than men, she emphasized, they are more susceptible to stroke. Dr. Bushnell also discussed stroke health disparities and her research on preventing recurrent strokes.
The meeting dialogue continued, delving into the proliferation of FSR-derived acute stroke performance data dashboards, rural health efforts and the importance of timely, thrombolytic care for stroke patients.
“Despite progress in stroke medicine, the disease remains the fifth-leading cause of death and the main cause of permanent adult disability in the U.S.,” Dr. Romano said. “For ischemic stroke, the use of a clot-busting agent in those that arrive early has increased from 70% in 2010 to 93% in 2023. Our registry has been vital in these efforts, with treatment with thrombolytics within 45 minutes of a hospital arrival increasing from 6% to 84%. I am proud to say Florida has one of the fastest treatment times in the nation.”
The meeting concluded with lightning rounds amplifying the ways the FSR is improving stroke outcomes. Topics of note included stroke prevention, health care system performance, care transitions and treatment strategies.
“The FSR has made significant strides this year and looks forward to continued success,” Dr. Romano said. “As the registry grows, it aims to expand its coalitions and develop learning communities to create a fully integrated and highly reliable system of stroke care, resulting in even better outcomes.”
Tags: Dr. Carolina Gutierrez, Dr. Jose Romano, Florida Stroke Registry, neurology, neuroscience, stroke