Making the Transition: An Integral Part of Stroke Care
The Florida Stroke Registry aims to educate stroke survivors, families and providers on the critical “transition of care” phase.
Irene Waldron, 43, was at work one day a little more than a year ago when she started feeling odd. She called her husband Philip, who, as luck would have it, was home sick that day. As soon as Waldron started talking, Philip knew something was wrong.
“She was slurring her words really heavily. I thought she was messing with me, so I told her to stop it,” he said.
Waldron told her husband she wasn’t teasing, so he asked her to turn on FaceTime. When the video came on, he saw that one side of Waldron’s face was frozen. A high school health teacher, he recognized her symptoms right away.
“I said, ‘I think you’re having a stroke. You need to not move and call for help right now,’” Philip said, just as Waldron’s left side gave out and she fell.
A coworker happened to see Waldron lying on the floor, and picked up her phone. Philip told him to call 911. Within 90 minutes, Waldron was on the operating table.
According to her doctor, the stroke was “one of those freak things,” a dissection of the carotid artery: genetic, though likely exacerbated by high blood pressure. While Waldron was left with a craniotomy and left-side paralysis, her colleagues’ quick response and effective hospital care meant the best prognosis possible.
However, Waldron’s hospital time was perhaps the easiest part of her stroke recovery. Doctors identified the same issue on the other side. Now back at home, Waldron must do the work on her own to reduce the possibility of a second stroke.
A Critical Phase in Stroke Recovery and Prevention
Since one in four stroke survivors will have a second stroke, leaving the hospital marks an especially vulnerable time. It’s called the “transition of care” phase.
“Everything is great when you’re in the hospital, because everybody’s doing exactly what they should be doing as quickly as they can. They’re attending to you, everybody’s watching you,” said Carolina Marinovic Gutierrez, Ph.D., associate director of the Florida Stroke Registry (FSR) at the University of Miami Miller School of Medicine. “But when you transition out of the hospital, that’s where you may experience a gap in care that may result in a poor stroke outcome like a hospital readmission or even death.”
Education on Transitions of Care
A consortium of 181 Florida hospitals, the FSR was formed in 2012 to improve the quality of stroke care. The FSR analyzes hospital data to produce an annual hospital “report card” that allows them to review stroke care performance across a number of care measures.
According to Dr. Gutierrez, the FSR has met its goal on that front. In the past decade, the quality of hospital care for strokes has improved considerably. Now the organization is turning its attention to the critical transition of stroke care phase.
Digital Stroke Awareness Campaign
To bolster stroke awareness, the FSR has recently launched a digital educational campaign, a series of videos featuring an animated character named Victor, a “stroke victor” (terminology preferred by the FSR to “stroke victim”).
In the series, Victor must first confront, then adopt, a series of lifestyle changes to prevent a second stroke or other poor outcomes. These changes, which could apply to anyone managing a chronic disease, include exercise, healthy eating and stress reduction.
But prevention of a second stroke requires more than individual efforts.
“A lot of times it’s about the knowledge base you have and a good support system. If your caregiver, your family and your friends know about and are supportive of the lifestyle changes you should make, you’ll have a better likelihood of a good stroke outcome,” said Dr. Gutierrez.
The FSR’s campaign, which will be distributed through multiple web and social media channels, also encourages providers to take a tailored approach to stroke care.
“Every family, every individual, is obviously a little bit different, with possibly different cultural backgrounds and culinary customs that should be considered by physicians and health care professionals consulting stroke patients,” said Dr. Gutierrez.
Dr. Gutierrez added, “I’m proud to be a part of the FSR, which maintains the goal of improving the quality of stroke care in Florida for all. Our latest community outreach and stroke awareness endeavor gives us a new way to help Floridians stay healthy.”
Tags: community outreach, Dr. Carolina Gutierrez, Florida Stroke Registry, neurology, stroke, stroke care guidelines, stroke outcomes, stroke prevention