Better Stroke Care Protocols Don't Hinge on Hospital Size

Systemwide, "the key is to have a neuroscience coordinator and stroke educator—people who are dedicated to providing that service to everyone who gives care in the hospital," says Shephard.

Another one of the chief enablers of that effort is technology, predominantly through telemedicine.

For smaller hospitals that may be independent and cannot afford the investment in a neuroscience coordinator, a stroke educator, and a vice president like Shephard, or for whom stroke may not be the educational priority at that moment, developing certified stroke centers may be an option.

Virginia, thanks to efforts from Bon Secours and others to share their expertise, now has 36 stroke centers. When the task force was started, it had six. Bon Secours has also expanded its teleneurology capabilities to offer smaller hospitals expertise in their emergency departments 24-7. That's where smaller hospitals, not owned by Bon Secours, fit into the equation.

"That's one of the components of our success," says Shephard. "We're developing certified stroke centers in hospitals as small as 75 beds."

Rappahannock General, which has 75 beds and a clinical affiliation agreement with Bon Secours Virginia Health System, now has teleneurology with 24-7 backup and is on track to becoming a certified stroke center by next year.