Although it is widely recognized that time is of the essence in the management of stroke, there are currently few efficient stroke centers that prospective new centers may emulate. This book offers a concise and practical guide on how to set up and run an acute stroke service tailored to the needs of the individual center as a provider of primary, secondary or tertiary care. All aspects of the subject are tackled. Essential knowledge on current imaging and treatment options is provided and guidance is offered on organizing a site-specific stroke pathway so as to ensure the quickest possible provision of treatment. The authors played an integral part in the development and operation of one of Europe's most successful early stroke centers and also have experience of the factors that can undermine the creation of world-class stroke units. This handbook will be an invaluable source of information for every member of the stroke team.
Professor Iris Quasar Grunwald studied Medicine in Germany and did her residency training in Neurology and Radiology at the Saarland University, where she became Co-director and Associate Professor of Diagnostic and Interventional Neuroradiology. She obtained her PhD in Radiology and Neuroradiology and a Master in Health Economics and Hospital Management. Dr. Grunwald has published more than 70 peer reviewed articles and several book chapters, mainly in the field of neurointervention. She has specific expertise in procedures such as intracerebral intra-arterial fibrinolysis and thrombectomy for emergency stroke therapy and intracranial angioplasty and stenting. Professor Grunwald has an international reputation in implementing acute stroke interventions and has been involved with research projects related to building and enabling acute stroke interventions regionally within the Saarland, nationally within Germany as well as internationally as European Principal Investigator in international clinical trials related to revascularisation in acute stroke. In addition she has conducted several lecture tours to leading US clinical stroke centers on the subjects of acute stroke intervention and management. In February 2009 she transferred her practice to the UK, Oxford University, to build up a stroke service within the Acute Vascular Imaging Centre in Oxford from where she leads several international trials.
Part I: Understanding your goals: The Why-What and Who: What is Stroke?- Guidelines, Regulations-Sources of supporting information .- Who can support this project.- Simplified steps of the stroke pathway.- Defining your priorities.-. Walking the steps and defining your own pathway and goals on the way.- Bringing your goals into shape.- Examples of treatment pathways.- Specific pathways in special cases.- Modern Concepts Part II: Planning: Strategic/Business Management.- Who manages your Project.- Project management plan.- Establishing whom and what you need in the stroke pathway.- stablishing your resources (equipment, staff, space).- Budget and time frame.- Risk assessment and Management. Part III: The Team : Setting up a project team Part IV: Getting started: Work packages.- Examples for Work Groups. Part V: Evaluation: Monitoring Project Performance.- Evaluating your work by monitoring times and outcomes.- Dissemination.- Redefining your goals (e.g. expand service).- Closing remarks.
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