# Presentation: 723159

## Stroke Systems of Care

- Working with the Texas EMS System

## Stroke System of Care Partners

- Department of State Health Services
- Cardiovascular Health and Wellness Program
- Office of EMS/Trauma Systems Coordination
- Governor’s EMS and Trauma Advisory Council (GETAC)
- Regional Advisory Councils (RAC)
- Texas Council on CVD and Stroke
- American Heart Association/American Stroke Association – South Central Affiliate

## Phased Projects of Initiative

- Phase I – Pilot Training of Texas EMS Responders 2005 - 2006
- @57,000 EMS responders in Texas
- 22 Regional Advisory Councils (RACs)
- 200 CDs
- Phase II – Stroke Systems of Care 2007 - 2008
- 426 CDs into 5700 Online Keys
- Develop RAC Stroke Committees and Stroke Transport Protocols

## Phase 1 - Pilot Project

- 2004 – Online Training Need Identified by Office of EMS/Trauma Systems – 26 CDs purchased with Stroke Belt Consortium Grant
- 2005 – Additional 400 AHA/ASA Stroke Prehospital Care Training CDs Purchased through CHW
- Dec. 2005 – Partner meeting held
- Feb. 2006 – Presentation to GETAC and Texas RAC Chairs
- One RAC Agreed to Pilot the CD

## CD Pilot Project Objectives

- Identify how best to implement EMS training on stroke with the 22 RACs in Texas
- Increase the knowledge of EMS responders on signs, symptoms and treatment of stroke
- Improve emergency response
- Improve health outcomes

## CD Pilot Project

- 20 CDs provided to Piney Woods RAC (Trauma Service Area G)
- Met with PWRAC Pre-hospital Committee
- 19 EMS Provider Agencies in PWRAC Used the CDs
- Output: Trained 100% (268) of EMS Responders (EMT Basic-Paramedic) in classroom mode using 20 CDs

## CD Phase I Project Lessons Learned

- Training in classroom mode was more efficient
- EMS Responders on whole liked the training CDs and learned more on stroke identification and transport
- One CD trained 10 staff/class
- Difficult process getting CEU’s for each responder with one CD
- Prefer to challenge the course or have online training

## Phase II – Stroke Systems of Care

- 2005 – Legislature enacted SB330:
- State-wide Stroke Transport Plan
- Stroke Facility Criteria
- 2005 – 2006 - GETAC Stroke Committee develops draft guidelines, with RAC input, on stroke transport plan and stroke facility criteria
-  2007 – GETAC Stroke Committee recommendations presented to GETAC and DSHS for consideration as rules

## Texas Stroke Systems of Care Initiative Components 

- Three of four components of the system being addressed in this initiative:
- Development of Stroke Committees in Regional Advisory Councils (RACs)
- Development of Regional Stroke Transport Protocols
- Emergency Medical Services Training
- Development of Stroke Centers Within Hospitals

## Phase II – Stroke Systems of Care

- AHA/ASA offered access to an online training program in exchange for CDs
- 5700 Online Keys (passcode) available
- RACs provided input on project, including distribution of keys and level of responders to train
- 21 RACs signed up for System of Care project:
- RAC Stroke Committee Developed or Updated
- RAC Stroke Transport Plan Developed or Updated
- Training offered to EMS Responders

## Phase II – Stroke System of Care – Current Outputs

- Training provided to RAC Key  Managers
- Keys allotted to RACs
- Online Website Page Created
- Evaluation Plan Developed
- Pre Assessment of RAC status
- Post Assessment of RAC status
- Evaluation in March and June 2008

## Contacts

- DSHS CHW– Jennifer Smith, Brett Spencer, Velma Ortega
- _[firstname.lastname@dshs.state.tx.us](mailto:firstname.lastname@dshs.state.tx.us)_
- 512-458-7200
- _[www.dshs.state.tx.us/wellness/stroke.shtm](http://www.dshs.state.tx.us/wellness/stroke.shtm)_
- Office of EMS/Trauma Systems Coordination – Steve Janda
- 512-834-6745
- www.dshs.state.tx.us/emstraumasystems
- AHA/ASA SCA – Remmy Morris, Peggy Lane
- _[Firstname.lastname@heart.org](mailto:Firstname.lastname@heart.org)_
- 512-433-7200
- 		www.americanheart.org