Critérios para a Certificação
dos Centros de AVC

Propósito

O objetivo do programa de certificação de centros de AVC é aumentar a qualidade do cuidado ao AVC na Índia, com o objetivo final de melhorar os desfechos para os pacientes.

Após o cumprimento dos critérios, incentivaremos os hospitais a solicitarem a certificação como Centros de AVC WSO/NABH. A certificação dos centros de AVC é uma etapa prioritária para orientar o cuidado nacional do AVC, por meio da aplicação de protocolos baseados em evidências que abrangem toda a linha de cuidado. Portanto, trabalharemos em conjunto com as Sociedades Médicas e Gestores de Saúde de cada país (Ministérios da Saúde/Secretarias de Saúde).

Este programa foi desenvolvido para garantir a implementação de elementos prioritários nos centros de AVC, aumentando a qualidade e a segurança do atendimento, além de melhorar os resultados em longo prazo. Com uma equipe de especialistas em AVC, ofereceremos sugestões para a melhoria dos serviços, materiais para treinamento de equipes, educação continuada, publicações científicas, além da certificação internacional publicada em nosso site e no aplicativo que estará disponível à população. Esperamos que, no futuro, a certificação também contribua para uma melhor remuneração dos serviços de saúde.

Documentos que devem ser enviados na Plataforma

Documentos que devem ser enviados na Plataforma
CriteriaEssential Stroke CenterAdvanced Stroke Center
Access to hyperacute stroke care  
Protocols for rapid evaluation and diagnosis of stroke patients in Hospital/ Emergency department 24hours/day, 7days/week, with time metrics assessmentMandatoryMandatory
Access to basic diagnostic services  
Laboratory blood test 24/7 (CBC, electrolytes, urea, glucose, INR, PT)MandatoryMandatory
Electrocardiogram (12 lead) 24/7MandatoryMandatory
Computed Tomography (CT) scan brain 24h/7 daysMandatoryMandatory
Capability to do CT Angiography (CTA) 24/7RecomendadoMandatory
Transthoracic EchocardiogramMandatoryMandatory
Vascular Doppler ultrasoundMandatoryMandatory
Holter monitorsRecommendedRecommended
Access to advanced diagnostic services  
Magnetic Resonance Imaging (MRI) Mandatory
Capability to do MR Angiography Mandatory
CT or MR Perfusion scans Recommended
Prolonged ECG monitoring devices Recommended
Transcranial Doppler Recommended
Transesophageal Echocardiogram Recommended
Access to emergency medical services –EMS– (ambulance)? ( ) Yes ( ) NoRecommendedRecommended
If yes:  
Training of ambulance crews to identify stroke signs using FAST mnemonic or similarRecommendedRecommended
Work with ambulance systems to have stroke identified as a high priority transport emergencyRecommendedRecommended
Access to nurses and nursing assessment with stroke training  
Acute care settings (the training should be documented, at least 4 hours/year – the documentation can be uploaded in the platform or should be presented during the onsite visit)MandatoryMandatory
Stroke unit settings (the training should be documented, at least 4 hours/year – the documentation can be uploaded in the platform or should be presented during the onsite visit, including stroke unit protocols, neurological assessment and swallow screen)MandatoryMandatory
Access to physicians with stroke expertise in acute stroke care available 24h/7 daysMandatoryMandatory
Check below the specialist responsible for thrombolysis treatment in your hospital (check all available)  
Neurologist( )( )
Neurosurgeon( )( )
Emergency physician  
Intensivist( )( )
Other speciality( )( )
Access to stroke specialists through telestroke modalities, and teleradiology( )( )
Access to physicians with expertise in stroke prevention and stroke rehabilitation Recommended
Program to develop and maintain core competencies and stroke careMandatoryMandatory
Access to acute inpatient stroke care, where admitted stroke patients are cared for on:Mandatory (1 available, the item is positive)Mandatory (1 available, the item is positive)
Stroke Unit (a defined group of beds, staff, and protocols that are used for the acute care of patients with a stroke)( )( )
Clustered model on same ward( )( )
Access to acute Intravenous thrombolysis  
IV thrombolysisMandatoryMandatory
Members of a interdisciplinary stroke team  
Neurologist with stroke expertise (or Stroke physician in some countries)MandatoryMandatory
Stroke NursesMandatoryMandatory
Nursing assistantsMandatoryMandatory
PharmacistRecommendedRecommended
Social worker/case managerRecommendedRecommended
Palliative Care teamRecommendedRecommended
PhysiotherapistMandatoryMandatory
Occupational TherapistRecommendedRecommended
Speech-Language PathologistMandatoryMandatory
NeurosurgeonRecommendedMandatory
Neurointerventionalist (Interventional Neurologist OR Endovascular Neurosurgeon, OR Interventional Neuroradiologist) Mandatory
Access to stroke unit protocols to guide acute stroke care based on best practice guidelines (Medical and nursing assessments)  
Swallowing assessment performedMandatoryMandatory
Nutrition, hydrationRecommendedRecommended
Functional status, mobility, DVT riskRecommendedRecommended
Level of dependencyRecommendedRecommended
Skin IntegrityRecommendedRecommended
Bladder and bowel continenceRecommendedRecommended
Temperature managementRecommendedRecommended
Positioning, mobilizationRecommendedRecommended
Access to stroke prevention therapies such as antiplatelet therapy, anticoagulants, lifestyle change recommendations, blood pressure managementRecommendedRecommended
Access to advanced interventions:  
Endovascular thrombectomy 24/7 Mandatory
Neurosurgery for hemorrhagic stroke 24/7 (including clipping and intraventricular drain placement)RecommendedMandatory
Hemicraniectomy for ischemic stroke 24/7 Mandatory
Acute inpatient stroke unitsRecommendedRecommended
Intensive care unit on siteRecommendedMandatory
Products to reverse coagulopathyRecommendedRecommended
Access to stroke rehabilitation services  
Early access to rehabilitation therapies – including cross training of skills to nurses, nursing assistants and family membersRecommendedRecommended
Early functional assessments, goal setting and individualized rehab plans developedRecommendedRecommended
Organization of Stroke Care  
Stroke DirectorMandatoryMandatory
Nurse CoordinatorMandatory 
Stroke Task Force (meets monthly) discusses data, guides, performance, improvementMandatoryMandatory
Interdisciplinary meetings weekly to discuss patient progress against treatment goals; update management plansRecommendedRecommended
Patient and family education, skills training, and involvement in care planningRecommendedRecommended
Discharge planningRecommendedRecommended
Stroke training programs for all levels of healthcare providersRecommendedRecommended
Participation in quality assessment of services (registry) – 4 months of data collection in the registry and performance measures must be included in the platform before the visitRecommendedMandatory
Printed stroke patient educational materialsRecommendedRecommended
Treatment Requirements  
Thrombolysis (minimum number recommended per year)1020
Thrombectomy (minimum number recommended per year) 10
Coordinated stroke care provided across geographically discrete regions  
Stroke pathways that define movement of stroke patients across region to higher and lower levels of services as requiredRecommendedRecommended
Coordinated referral system Recommended
Provide telestroke consultations to smaller and more rural centers Recommended
Education of populationRecommendedRecommended
Implement research in stroke Recommended
Organização

Nossos parceiros e patrocinadores

Alcançar nosso propósito de uma vida sem AVC é uma tarefa que não podemos realizar sozinhos. Estamos empenhados em construir nossas parcerias globais, regionais e nacionais para expandir e entregar melhorias na prevenção, tratamento e apoio para reduzir o impacto do AVC.

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