Lessons Learned On The Journey To Primary Stroke Center Certification


In August 2009, Santa Barbara Cottage Hospital became the only facility on the central coast to achieve Primary Stroke Center certification from The Joint Commission, demonstrating a solid commitment to meeting or exceeding national standards and guidelines for improving stroke outcomes.  


“We want to make sure we’re doing what’s best for patients, and adhering to The Joint Commission’s stroke care criteria is in everyone’s best interest,” says Phil Delio, MD, stroke neurologist and medical director of the stroke program at Cottage. “Paramedics across the country—including those in Los Angeles—are increasingly routing stroke patients to hospitals with a certified stroke center because of the specialized care available at these locations. We recognized and responded to the need to keep pace with this trend and to demonstrate our commitment to stroke care.”


•    Director's Letter
•    Saving the Brain 2009
•    Radiosurgery
•    Stroke Center Certification
•    AVM Case Study
•    Diffusion Tensor Imaging
•    Research Tools
  Intramedullary Tumors
  Hans Keirstead

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At Cottage, a multidisciplinary team of clinicians and nurses worked toward certification for four years. A committee meeting was held every two weeks throughout the process to identify areas for improvement. Cottage implemented a number of changes to its stroke care protocols as a result of the process. They included:

  •      written protocols for treatment of different types of stroke and triage of patients in the emergency department
  •      pre-hospital forms for paramedics to use in transit
  •      order sets and sheets for use once a patient arrives at the hospital dictating how nurses record and chart the patient’s progress, how the patient is evaluated, and how medications are administered
  •      quality improvement meetings to review cases that fall below standard


Cottage provides stroke interventions, such as clot retrieval and intra-arterial thrombolytic therapy, that are found primarily in larger medical centers. In addition, Cottage uses the expertise of a neurocritical care specialist.


“The most striking difference in our stroke care now compared to pre-certification is that each person involved in caring for patients does so as part of an integrated team rather than in his or her own isolated arena,” says Dr. Delio. “Obtaining our primary stroke center certification truly speaks to the strength of our program and infrastructure.”


To learn more about Cottage’s experience with the stroke certification process or to obtain copies of our protocols and guidelines, e-mail stroketeam@sbch.org.


Look for more information about neurocritical care at Cottage in the next issue of Neurotransmitter.



Stroke Composite Scores—2009

The composite quality-of-care measure indicates how well Santa Barbara Cottage Hospital provides appropriate, evidence-based interventions for each patient compared with all hospitals in the American Heart Association’s “Get With the Guidelines” database.





"The Joint Commission requires applicants for Primary Stroke Center Certification to demonstrate excellence in 10 core measures, including deep vein thrombosis prophylaxis, administration of thrombolytic therapy and dysphagia screening. After Santa Barbara Cottage Hospital implemented the infrastructure and process changes necessary to achieve certification, process and outcomes scores rose from the 70 percent range on most measures to nearly 100 percent."

Phil Delio, MD
Stroke neurologist



For more information, please e-mail sbni@sbch.org.