The consultancy scope of service for 2026
includes:
1.
Hyper-Acute Stroke Workflow Design
Stroke Code Implementation: Establishing a
24/7 "Code Stroke" protocol that bypasses traditional registration
delays to move patients directly to imaging.
Triage Prioritization: Training emergency
staff to use standardized scales (like the Cincinnati Prehospital Stroke Scale
or NIHSS) to identify stroke symptoms within minutes of arrival.
Door-to-CT/MRI Targets: Designing
workflows to ensure imaging is completed within 20–25 minutes of patient
arrival.
2.
Clinical Protocols & Pathway Development
Consultants draft evidence-based pathways
for the first 24 hours of stroke care:
Thrombolysis Protocol: Standardizing the
administration of IV rt-PA (Alteplase/Tenecteplase), including
inclusion/exclusion checklists and dosage calculation tools.
Door-to-Needle (DTN) Optimization:
Implementing strategies to achieve a median DTN time of <60 minutes (with a
target of <45 minutes for 2026 benchmarks).
Post-Thrombolysis Monitoring: Developing
ICU/Stroke Unit SOPs for blood pressure management and neuro-check frequencies
to prevent hemorrhagic transformation.
3.
Infrastructure & Specialized Resource Audit
24/7 Imaging Readiness: Ensuring CT/MRI
facilities and radiologist availability are guaranteed around the clock.
Stroke Unit Standards: Designing a
dedicated Stroke Unit or designated beds with continuous telemetry and
specialized nursing care.
Pharmacy & Lab Integration: Ensuring
the immediate availability of thrombolytic agents and rapid turnaround for
PT/INR and blood glucose tests.
4.
Stroke-Specific Quality Indicators (2026 Metrics)
Consultants establish real-time dashboards
for the 8 Mandatory Stroke Indicators:
Median Door-to-Needle Time: The primary
metric for efficiency.
NIHSS Documentation: Percentage of
patients with a recorded NIH Stroke Scale score at admission and discharge.
Dysphagia Screening: Percentage of
patients screened for swallowing difficulties before any oral intake.
Antithrombotic Therapy: Percentage of
patients started on antithrombotics by the end of hospital day two.
DVT Prophylaxis: Use of preventive
measures for deep vein thrombosis in non-ambulatory patients.
Statin Prescribing: Percentage of ischemic
stroke patients discharged on statin medication.
5.
Specialized Staff Training
Nursing Competency: Training nurses on the
NIHSS assessment, GCS monitoring, and early recognition of neurological
deterioration.
Multidisciplinary Drills: Conducting
unannounced "Code Stroke" mock drills involving EMS, ER, Radiology,
and Neurology.
Rehabilitation Integration: Training
physiotherapy and speech therapy teams on early mobilization and swallow-safety
protocols.
6.
Digital & Portal Management
NABH Portal Support: Managing the
application specifically under the "Stroke Centre" certification
category.
Evidence Compilation: Uploading
time-stamped logs of recent stroke cases to prove adherence to time-targets.
Desktop Assessment (DA): Managing the
digital review of clinical pathways, specialist credentialing
(Neurologists/Neuro-radiologists), and equipment maintenance logs.
7.
Community & EMS Outreach
Pre-Hospital Coordination: Training local
ambulance services on stroke recognition and "Pre-Notification" to
the hospital while the patient is in transit.
Patient Education: Developing materials
for "FAST" (Face, Arm, Speech, Time) awareness and secondary stroke
prevention for discharged patients.
Timeline & Validity (2026)
Preparation: 4–6 months (requires
established neurology and imaging services).
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