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Integration expands, improves stroke care

On September 12 — the day of the official integration of the Hospital of Saint Raphael and Yale-New Haven Hospital, the TeleStroke program was up and running on the Saint Raphael Campus, ready to help stroke patients who need expert care, quickly.

Through TeleStroke, YNHH stroke specialists use videoconferencing and imagesharing technology to examine patients remotely, help make diagnoses and recommend treatment.

Offering TeleStroke on Day One of integration is one example of the behind-thescenes planning and hard work by stroke program staff members on both campuses. They ensured a seamless transition to a combined stroke program that further advances and expands services for patients. TeleStroke is now available on the SRC during off hours and weekends, when an attending stroke physician is not on call.

Since July 2012, stroke neurologists Joseph Schindler, MD, and James McVeety, MD, have worked with their physician-colleagues to align practice protocols to ensure stroke patients receive a consistent experience on both campuses. "This integration has directed both stroke programs to re-organize the coordination of acute stroke care in greater New Haven", said Dr. Schindler. "Although we are still in transition, we are forming new relationships among medical practitioners which will ultimately benefit stroke patients."

Staff members have also worked to integrate physician call coverage and clarify which acute-care services are provided on which campus. Both EDs accept and treat patients who present with acute stroke symptoms; those requiring advanced diagnostic, surgical or interventional procedures may be transferred to the York Street Campus.

"Both the ED and inpatient staffs have embraced Telestroke," said Anne Froehlich, RN, SRC stroke coordinator. "Patients and families also appreciate that they have a stroke attending available during off hours and there are no delays in treatment."

Thanks to the integration, stroke patients can now receive rehabilitation without leaving the Yale New Haven Health System, including inpatient intensive rehabilitation on the SRC and outpatient rehab at the Grimes Center. They can also attend a support group for patients and their loved ones held monthly on the SRC.

In addition, the Stamp Out Stroke (S.O.S.) community outreach and education program — made up of volunteer nurses from both campuses — is now more widely available. The S.O.S. team visits venues throughout the community to help people identify stroke risk factors and understand the importance of calling 911.

"With the integration of two Joint Commission-certified Primary Stroke Centers, we're bringing together experienced clinicians with extensive stroke expertise," said Karin Nyström, APRN, York Street Campus stroke coordinator. "We're providing evidence-based care to our patients, along with a host of special services a tertiary care medical center has to offer."

Yale-New Haven Hospital news release

Yale-New Haven Hospital is a nationally recognized, 1,541-bed, not-for-profit hospital serving as the primary teaching hospital for the Yale School of Medicine. Yale-New Haven was founded as the fourth voluntary hospital in the U.S. in 1826. Today, the hospital's two New Haven-based inpatient campuses include Yale-New Haven Children's Hospital, Yale-New Haven Psychiatric Hospital and Smilow Cancer Hospital. YNHH has a combined medical staff of about 4,500 university and community physicians practicing in more than 100 specialties. YNHH's York Street campus and associated ambulatory sites are Magnet-designated by the American Nurses Credentialing Center.

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