Michigan Administrative Code › Department - Health and Human Services › Behavioral Health and Developmental Disabilities Administration › Statewide Stroke System › Part 1 - GENERAL PROVISIONS › Section R. 330.253 - Definitions; P to V

Current through Vol. 24-12, July 15, 2024
Rule 3.
(1) As
				  used in this part:
(a) "Protocol" means a
				  patient care standard, standing order, policy, or procedure for providing EMS
				  that is established by an MCA and approved by the department under section
				  20919 of the code, MCL
				  333.20919.
(b) "Provisional" means a one-time,
				  temporary-time-limited status conferred on a facility by the department that
				  most closely matches the current level of care based on the published criteria
				  for certification for which it is applying.
(c) "PSRO" or ""professional standards review
				  organization" means a committee established by a life support agency or MCA for
				  the purpose of improving the quality of medical care, as provided in section 1
				  of 1967 PA, 270, MCL
				  331.531.
(d) "Quality improvement program" means
				  actions taken by a life support agency, MCA, stroke center, or jointly between
				  a life support agency, MCA, or stroke center with a goal of continuous
				  improvement of medical care in accordance with the code. Actions must take
				  place under a PRSO, as provided in sections 1 to 3 of 1967 PA 270, MCL
				  331.531 to
				  331.533.
(e) "RPSRO" or "regional PRSO" means a
				  committee established by the regional stroke system for the purpose of
				  improving the quality of stroke care within a recognized stroke region as
				  provided in sections 1 to 3 of 1967 PA 270, MCL
				  331.531 to
				  331.533.
(f) "Regional stroke plan" means a written
				  plan prepared by a regional stroke advisory council, and approved by the
				  regional stroke system, that is based on minimum criteria established by the
				  department.
(g) "RSAC" or "regional
				  stroke advisory council" means a committee established by a regional stroke
				  system whose function is to provide leadership and direction in matters related
				  to stroke system development in their region, and to monitor the performance of
				  the stroke agencies and healthcare facilities within the region, including, but
				  not limited to, the review of stroke deaths and preventable complications, and
				  it is comprised of the following:
(i) MCA
				  personnel.
(ii) EMS
				  personnel.
(iii) Life support
				  agency representatives.
(iv)
				  Healthcare facility representatives.
(v) Physicians.
(vi) Nurses.
(vii) Consumers.
(h) "Regional stroke system" means an
				  organized group comprised of the local MCA within a region, that integrates
				  into existing regional trauma network or regional systems of care authority and
				  is responsible for appointing a regional stroke advisory council and creating a
				  regional stroke plan.
(i) "Regional
				  systems of care authority" means an organization recognized by the department,
				  comprised of approved MCAs within a region, also approved as the Regional
				  Trauma Network, which provides clinical oversight for the regional trauma
				  system, regional stroke system and regional STEMI system within the
				  region.
(j) "Statewide stroke care
				  advisory subcommittee" means a stroke care advisory subcommittee that acts as
				  the department's subject matter experts for the clinical and operational
				  components of stroke care. As the system matures and signals readiness to
				  capitalize on efficiencies, the system will merge into the statewide stroke
				  care advisory subcommittee and the statewide STEMI care advisory subcommittee
				  into the statewide cardiovascular care advisory subcommittee.
(k) "Statewide stroke registry" means a
				  system for collecting data that the department manages, analyzes, and
				  disseminates results.
(l)
				  "Statewide stroke system of care" means a comprehensive and integrated
				  arrangement of emergency services personnel, stroke centers, equipment,
				  services, communications, MCAs, and organizations necessary to provide stroke
				  care to all patients within a particular geographic region.
(m) "STEMI" means an ST-segment elevation
				  myocardial infarction defined by symptoms of myocardial infarction associated
				  with an ST-segment elevation on an ECG.
(n) "Stroke" means a cerebrovascular disease
				  that causes a sudden interference in the blood supply to the brain causing
				  neuronal injury with neurological symptoms. This occurs when a blood vessel in
				  the brain is blocked by a clot or a vessel rupture.
(o) "Stroke bypass" means to forego EMS
				  transport of a patient to the nearest healthcare facility for facility whose
				  resources are more appropriate to the stroke patient, pursuant to direction
				  given to pre-hospital EMS by online medical direction or predetermined triage
				  criteria, as established by department-approved protocols.
(p) "Stroke care" means diagnostic
				  evaluation, triage, acute intervention, emergency transport and other acute
				  care services for stroke patients who potentially require emergent medical or
				  surgical intervention or treatment, and may include education, risk reduction,
				  and subacute stroke management.
(q)
				  "Stroke center" means a healthcare facility designated by the department as
				  having met the criteria set forth by a department-approved, CMS-recognized
				  professional certifying organization as being any of the following:
(i) Level I or comprehensive stroke
				  center.
(ii) Level II or
				  thrombectomy capable stroke center.
(iii) Level III or primary stroke
				  center.
(iv) Level IV or acute
				  stroke ready center.
(r)
				  "Stroke diversion" means the re-routing of a stroke patient from a stroke care
				  facility that has 1 or more of its essential resources currently functioning at
				  maximum capacity, or is otherwise unavailable, to an alternate stroke care
				  facility to serve the best interests of the stroke patient.
(s) "Stroke response" means an individual who
				  has been identified as a potential stroke patient and requires the utilization
				  of the stroke care system.
(t)
				  "Triage" means classifying patients according to the severity of their medical
				  conditions.
(u) "Verification"
				  means an evaluation process conducted by a national professional certifying
				  organization to verify resources and improve stroke care.