Saudi Stroke Standards

Leadership and Skills Purpose To provide care givers with the skills and knowledge on how to support and care for a patient with stroke. Rationale  A stable, qualified workforce contributes effectively and efficiently to patient/family satisfaction and positive service delivery results.  Personnel satisfaction and retention reflect positively on outcome.  Cluster/network wide workforce leadership supports integrated teamwork.  There is unwarranted variation in distribution and availability of neurological, neurosurgical, and radiological expertise. Standards 1. All stroke patients, and those at risk of stroke should receive care from skilled, competent and experienced doctors and other healthcare professionals. 2. Clusters, networks, cities and regions should develop an organizational infrastructure and decision-making body to assist in addressing care issues, decision making, implementation, and problem solving. This is typically in the form of a stroke committee defined by a cluster, region or other overseeing body. 3. The use of telemedicine/tele-stroke resources and systems should be supported by healthcare institutions, government, payers, and vendors as one method to ensure adequate 24/7 coverage and care of stroke patients in a variety of settings. 4. Stroke education programs for general physicians, hospital personnel, and EMS personnel should be planned and regularly run to increase both the number of patients who are treated and the quality of care. 5. Multi-component quality improvement initiatives, which include ED education and multidisciplinary teams with access to neurological expertise, are recommended to safely increase the capacity and capability of hospitals providing stroke care. 6. The cluster should develop a uniform and fairly applied credentialing process that assesses and confirms the qualifications of licensed professionals who provide network services. 7. All organizations involved in stroke care should promote open communication and collaboration among disciplines and staff levels by: a) holding regular team, organizational, and divisional meetings, as appropriate to the organization. b) Providing feedback to personnel about their suggestions and recommendations. 8. All hospitals providing stroke care should establish a program of ongoing professional education which should include: a) A program of interprofessional education rounds within the stroke unit. b) Process for stroke unit staff to participate in regional, national and international educational opportunities in the care and management of stroke patients. c) Networking with interprofessional stroke teams in other facilities, networks, clusters and nationally. This will facilitate knowledge sharing, problem solving, collaboration, and increase consistency of stroke care delivery across clusters and nationally. 9. Regular meetings should be held between stroke physicians, vascular surgeons, vascular technologists and radiologists to monitor service performance, discuss clinical cases and provide feedback and education. Action needed  For patients: If you are the care giver of a patient with stroke, you are offered education on stroke, practical training on how to provide care, as well as contact details of support services before the patient with stroke leaves hospital.  For clinicians: Support care givers by offering them education on stroke, practical training on how to provide care, contact details of support services, and other information to support their own wellbeing before patients with stroke leave hospital.  For health services: Ensure processes and resources are in place to provide family members and care givers with education about stroke, practical training on how to provide care, access to support services (e.g. respite care), and other information to support care givers, before patients with stroke leave hospital.  Ministry of Health: Consider establishing the National HRD Standards Working Group or similar as a vehicle for the implementation of these standards.  SCFHS: I. Monitor and evaluate training programs to ensure compliance with standards for their respective professions II. Establish competencies required for licensing of health care professionals III. Grant licenses and license renewals to qualified health care professionals IV. Maintain an inventory of health care professionals currently licensed or certified to practice in KSA in the training databases established (database establishment) V. Collaborate with MOH divisions of standards & quality assurance, health regulation & legislation and the health training institutions in the implementation of these standards.  Organized system of stroke care including stroke units with a critical mass of trained staff (interprofessional team). If stroke unit not feasible, then mechanisms for coordinating the care of stroke patients to ensure application of best practices and optimization of outcomes.  All patients with moderate and severe stroke should be admitted to a geographically defined stroke rehabilitation unit that is staffed by an interprofessional team of healthcare providers. When post-acute stroke patients receive coordinated, interprofessional evaluation and intervention on a stroke rehabilitation unit there is a reduction in death and disability. QM