Saudi Stroke Standards

Workforce Purpose All employers should undertake a review of the current workforce and develop a plan for development and training to create a competent and skilled workforce and define critical cadres with shortages and develop plans for urgent attention to resolve these. Additionally, to define the numbers of new health workers required to be produced for effective service delivery over a given period of time; to define competencies required by the team in collaboration with regulatory bodies. To identify training needs and gaps for basic and post-basic levels by team and by location, and to develop training plans at the facility, cluster/network and national levels. To establish and maintain effective linkages with the health training institutions, other relevant ministries and regulatory boards, councils, development & implementation partners, and others as needed, for effective implementation of this standard. Rationale  Outstanding stroke care does not exist in a vacuum solely focused on the procedure but instead is part of a successful multidisciplinary team.  The stroke team comprises fully trained stroke physicians (vascular neurologists or neurointensivists), allied professionals, and nurses that are all led by a stroke physician with a strong background in the management of neurovascular disease. Standards 1. All organizations involved in stroke care should assess the type and number of personnel needed to accomplish its mission, goals, and objectives. Human resources planning should occur in conjunction with strategic planning, budget development, training and professional development. 2. All organizations involved in stroke care should assess its workforce as part of annual planning and prepare for future needs by: a. comparing the composition of its current workforce, including number of employees, skills, and demographics, with projected workforce needs; and b. determining how to close gaps, when possible, through recruiting, training or outsourcing. 3. The levels of nursing staff relate directly to the provision of good stroke unit care. Nursing staffing levels and skill mix should be appropriate to the size of the stroke unit and dependency of the patients. 4. Stroke intervention team: each stroke hospital should ensure 24/7 on-call schedule is available to provide acute stroke intervention. The acute stroke intervention team should have a minimum of three clinicians with training and qualifications in Acute Ischemic Stroke Interventions (AISI). This should include: I. The team should organize 24/7 acute emergency large vessel occlusion (ELVO) stroke coverage (possibly in a rotation system organized within a cluster/network). II. The stroke neurovascular interventionist, in collaboration with the stroke team, should have shared responsibility for preoperative and postoperative patient care with input from the appropriate specialties. III. AISI should ideally be practiced in neurovascular interventional teams with the possibility to exchange experience and knowledge. With regard to individual procedures, each acute stroke hospital will ensure appropriate staff coverage is available for safe and effective urgent stroke treatment. 5. Anesthesia team: there shall be 24/7 in hospital anesthesia coverage with anesthetists who have experience in caring for patients undergoing AISI.