Stroke care quality and outcomes

When it comes to treating stroke, every second counts. You can rely on the teams at Sharp Chula Vista Medical Center, Sharp Grossmont Hospital and Sharp Memorial Hospital to immediately diagnose and care for you. From diagnosis to treatment to recovery, we remain by your side to help you return to your daily activities and live your best life.

Our stroke care programs at Sharp Chula Vista, Sharp Grossmont and Sharp Memorial follow rigorous national standards and guidelines that can significantly improve outcomes for stroke patients.

Sharp Chula Vista Medical Center stroke care quality and outcomes

Sharp Chula Vista Medical Center is the South Bay leader for providing excellence in stroke care and has received the prestigious achievement award of Gold Plus from the American Heart Association. As a certified Advanced Primary Stroke Center, Sharp Chula Vista can treat all types of strokes quickly and effectively.

Getting treatment quickly, improving outcomes

Stroke can be a disabling disease, and minutes matter to reduce delays in treatment, and increase chances for recovery and survival. Excellent care and outcomes are achieved by providing standardized care and treatments the minute a persona arrives with stroke symptoms. Incidences of stroke continue to rise in the South Bay area. Last year, Sharp Chula Vista Medical Center treated over 620 (622) patients diagnosed with stroke, and that number is expected to rise by 7% next year to close to 700 (665).

Tenecteplase (TNKase): the “clot busting” medicine for ischemic stroke

The American Heart and American Stroke Association recommend using a “clot busting” medication called Tenecteplase (TNKase) for treatment of ischemic stroke within 4 ½ hours of onset of symptoms. The goal is to deliver this medication within 60 minutes of arrival for patients who qualify. At Sharp Chula Vista Medical Center, this goal has been met nearly 100% (94%) of the time, with over 75% (76%) of patients receiving the medication within 45 minutes of arrival. Equally important to timeliness of treatment, is ensuring safety of treatment. Major complications of the medication include bleeding, allergic reaction, and death, with a national average of approximately 6.4% versus 10.3% at Sharp Chula Vista Medical Center in 2023.

Thrombectomy for ischemic stroke

Another option to treat ischemic stroke available at Sharp Chula Vista Medical Center is the use of mechanical thrombectomy, which is a minimally invasive surgical procedure where the blood clot in the brain causing the stroke is attempted to be removed. Highly skilled providers at Sharp Chula Vista Medical Center have successfully removed these clots in over 80% (81%) of eligible stroke patients.

Patient outcomes

The goals for stroke recovery are for individuals are to remain independent, minimize disability and prevent repeat strokes from recurring. Successful achievement of these goals is attained under the guidance of a highly specialized team of providers, nurses, and therapists to address specific patient needs during their hospital stay and after discharge. Almost 90% (89%) of patients treated for stroke at Sharp Chula Vista Medical Center last year were discharged either home (53%) or to a rehabilitation facility (37%) for ongoing recovery.

Sharp Grossmont Hospital stroke care quality and outcomes

As a Comprehensive Stroke Center — the highest designation given by The Joint Commission in association with the American Heart Association/American Stroke Association — Sharp Grossmont Hospital has the experts and processes in place to treat all types of strokes quickly and effectively. Our highly skilled staff and enhanced response help increase a patient’s chance for long-term recovery and survival, while also decreasing the possibilities of side effects.

Since 2018, Sharp Grossmont has seen the largest volume of patients of all stroke centers in San Diego County. In 2020, we were sixth in patient volume of all California stroke centers. Sharp Grossmont received Comprehensive Stroke Center certification in February 2020. From calendar year (CY) 2020 to CY 2021, our volume has increased by 9%.

And we will continue to serve our community as needs increase, since we project our stroke patient volume to see a greater than 14% increase in 2022 compared to 2018.

Getting treatment quickly, improving outcomes

As a leader in stroke care, Sharp Grossmont has demonstrated exceptional performance on diagnosing and treating patients with stroke. The following information illustrates our extraordinary performance:

30 days post-carotid procedure

Here are rolling year-to-date volumes and complication rates for 30-day post carotid endarterectomy (CEA)/carotid artery stenting (CAS)/transcarotid artery revascularization (TCAR). The expectation is that asymptomatic CEA, CAS and TCAR stroke and death complication is less than 3% and symptomatic CEA/CAS/TCAR stroke and death complication rate is less than 6%.

Elective aneurysm repair

Thrombectomy for ischemic stroke

Patients arriving at Sharp Grossmont Hospital with ischemic stroke are quickly diagnosed and undergo surgery to remove a blood clot from inside an artery or vein.

Alteplase for ischemic stroke

Patients arriving at Sharp Grossmont with ischemic stroke quickly receive medicine to breakdown the clot causing the stroke. Over the last few years, Sharp Grossmont has proven to be successful in significantly decreasing the median door-to-needle time (DNT) for diagnosing stroke and administering clot-busting medicine (alteplase) to patients.

This direct to computed tomography (CT) scan procedure is called Stroke Stop. Stroke Stop includes standardized, defined roles and responsibilities; brief, but comprehensive assessment; and concurrent tasking. The stroke team has been successful in decreasing the median DNT by 13 minutes. As seen in the graph, CY 2022 through May shows DNT ≤ 60 minutes at 85%; ≤ 45 minutes at 80%; and ≤ 30 minutes at 53%.

Sharp Memorial Hospital stroke care quality and outcomes

As an Advanced Primary Stroke Center certified by The Joint Commission in association with the American Heart Association/American Stroke Association, Sharp Memorial Hospital has the experts and processes in place to treat all types of strokes quickly and effectively. Our highly skilled staff and enhanced response help increase a patient’s chance for long-term recovery and survival.

Getting treatment quickly, improving outcomes

As a leader in stroke care, Sharp Memorial has demonstrated exceptional performance in diagnosing and treating patients suffering from a stroke. We care for more than 700 stroke patients annually. We project our stroke patient volume for 2023 will have a 27% increase compared to 2020. As experts in stroke care, we have standardized processes to ensure patients receive the highest quality of care timely to minimize or eliminate life changing disabilities.

On arrival, the patient is expedited to advanced computer tomography (CT) scan imaging where they will be met by a highly skilled team of clinical experts including physicians, nurses, and technicians who are specially trained in stroke. Standardized procedures and defined roles result in concurrent tasking while a comprehensive assessment is completed. The interdisciplinary team's main goal is to identify patients experiencing stroke and expedite treatment to prevent long term disability.

Tenecteplase (TNKase) or “clot busting” medication for the treatment of an ischemic stroke

Patients arriving at Sharp Memorial with ischemic stroke symptoms quickly receive medicine to breakdown the clot causing the stroke. Over the last few years, Sharp Memorial has proven to be successful in significantly decreasing door-to-needle times (DNT) for administering to patients the clot-busting medicine called Tenecteplase (TNKase).

The American Heart Association and American Stroke Association advises the goal for Stroke Centers to give the “Clot Busting” Medication called TNKase within 30 minutes 50% of the time. Sharp Memorial has met and exceeded that goal each quarter knowing that faster treatment times equates to better patient outcomes.

Challenges meeting the goals surround determining eligibility for treatment and management of the patient’s blood pressure to ensure that decisions and care meet AHA Guidelines and are safe. The result of this careful, thorough evaluation is a complication rate of 3% versus the national average of 6.4%.

Thrombectomy for ischemic stroke treatment

Patients arriving at Sharp Memorial Hospital with ischemic stroke are quickly diagnosed and undergo a procedure to remove a blood clot from inside an artery. Only certain stroke centers are certified by the Joint Commission to perform this procedure and Sharp Memorial is one of the few centers in San Diego that does with excellent outcomes. In 2023, year to date, Sharp Memorial’s highly skilled interventional team restored the blood flow to the brain 75-100% of the time providing patients with optimal chance for recovery from their stroke.

Patient dispositions

Our goal is for everyone to return home. Sharp Memorial utilizes a specially trained stroke interdisciplinary team to help with that goal. The team includes physicians, nurses, occupational therapists, physical therapists, speech therapists and case managers. We are happy to report that the majority of our patients have returned home directly from the hospital (60%). Some stroke patients will need inpatient physical rehabilitation or a short stay in a skilled nursing facility before returning home, which is always our hope and goal.