Stroke Unit Support and Certification Program of Korean Stroke Society - The First Term Report

초록

Background: Stroke unit, which provide organized care by expert team in optimally monitored environment, is of proven efficacy for the acute stroke care. To recommend the establishment of stroke unit and also to control the quality of stroke care service, Korean Stroke Society has launched a stroke unit support and certification program since 2012. The result of first term and future change of 2nd term is presented. Method: Eight key elements were required (Table) for the 1st 3 year certification. In case of request, supporting programs such as clinical practice guideline, prototype written care protocol, and education materials were provided. Upon request, stroke unit committee member visited and reviewed every hospital. Final decision of certification was made and informed by the stroke unit committee, with feedback report to the hospital. Result: During the first term of 3 years, 43 hospitals with 231 beds were certified for the stroke unit. Mean number of beds in a stroke unit was 5.4, with 14.3m2 area for each. Most reason of non-certification was stroke nurse requirement, followed by monitoring function and stroke team requirement. Most frequent feedback report item was the routine medication outside clinical practice guideline, followed by violation of stroke unit admission criteria. Quality indicator of stroke care was compared between hospitals with and without stroke unit, and analyzed to have better performance in the hospitals with stroke unit. Conclusion: Stroke unit support and certification program has successfully implemented in nationwide stroke care hospitals in Korea. Further strengthened criteria will be applied for the 2nd term program from 2015 and the key elements will be presented. For further dissemination of stroke unit, support from Korean health insurance system is required.