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What It Takes to Build a Successful, Sustainable Stroke Service Line

By Monte Bostwick, CEO and Market President of St. Luke’s Health – East Texas

April 10, 2023 Posted in: Leadership

Few hospital services are as important to communities as timely, high-quality stroke care. That’s especially true in rural areas, where many miles may separate patients from medical services, amplifying the need to make every minute count.

At St. Luke’s Health-Memorial in East Texas, I regularly hear stories about how the team at our Joint Commission-certified Primary Stroke Center profoundly impacts the lives and futures of our patients. We serve an approximately 12-county area, and many of our patients live 30 to 50 minutes away from the hospital. Time makes all the difference in the world when a stroke occurs. Having a stroke center like ours that can handle many aspects of stroke care ensures patients receive the treatments they need fast.

Deploying best practices in stroke care and procuring innovative technology has allowed us to reduce the amount of time between symptom onset and intervention, which is a huge win for patient care. In addition, when patients need an intervention we don’t provide, the quality of our team allows us to transfer them to a larger institution, such as the Comprehensive Stroke Center at Baylor St. Luke’s Medical Center or St. Luke’s Health-The Woodlands Hospital, much faster than we could otherwise.

Leading With Service

One of the things I’ve learned during my career as a health care leader is when to get out of the experts’ way. Our stroke team is constantly pushing the envelope in pursuit of better patient care. 

My job is to give them the support they need and ensure I’m not hindering their efforts. I’m not a clinician, but I understand, from a 30,000-foot view, what we want to accomplish. With that kind of high-level perspective, I can remove obstacles to success and act as a facilitator in turning vision into reality. Leadership support is one of the elements that, in my experience, is essential for building a top-notch stroke service line, but that’s not where it ends.

Start With a Vision and Build Buy-In

The most important component of a successful stroke service line is also the most basic: a vision for what you want to accomplish. Health care leaders and key stakeholders must ask themselves some key questions.

“What resources do we have? What resources do we lack? Do we have the ability to learn, procure or invest in the resources we don’t have?” Answering these questions will help shape the contours of your program.

Part of establishing a vision for a stroke service line is building buy-in from the clinicians who will bring it to life. Involving the key clinical stakeholders in setting the vision for the program helps them feel invested in its success. At St. Luke’s Health-Memorial, we’re fortunate to have outstanding neurologists, neurosurgeons, emergency medicine physicians, radiologists, nurses and more who buy into our vision and are committed to caring for our communities. This team makes our stroke service line possible.

Embrace Innovation When It Aligns With Your Vision

One of the exhilarating things about medicine is it’s constantly evolving. Keeping pace with technological advances is another key element of our stroke program at St. Luke’s Health-Memorial.

Recently, we began using, a system that uses artificial intelligence to help identify and triage patients with potential large vessel occlusions, a major cause of ischemic stroke. This tool allows our team to detect and treat large vessel occlusions faster. It also allows physicians at the Comprehensive Stroke Centers in our health system to view patients’ images practically in real-time so they can prepare to receive the patients for interventions, if necessary.

It’s important to recognize when a new technology has the potential to make a difference for your program. wasn’t on our radar at first. Once we learned more about it, however, we recognized its potential value for our patients—and moved to procure it. Investing in leading-edge technologies such as ensures our program keeps moving forward. 

Commit to Continuous Evaluation and Improvement

Every high-quality stroke program should commit to continuous improvement. This requires constant self-scrutiny.

At St. Luke’s Health-Memorial, we’re always evaluating the state of our stroke program to identify and close any gaps, and, most importantly, to improve. This commitment to constant evaluation isn’t easy, and it requires the entire team to be onboard.

Part of our commitment to evaluation involves gleaning outside experts’ perspectives. This is why I love when an outside entity, such as The Joint Commission, evaluates our program. Pursuing and maintaining Primary Stroke Center accreditation requires ongoing investment in the program. This investment pays off when Joint Commission representatives evaluate our stroke center with fresh eyes and share a new best practice or find ways to strengthen our care. We use this feedback to improve our program. That’s extremely gratifying.

As your stroke program grows, let the original vision for the service line guide you. Does the vision remain intact? What is necessary to fulfill and sustain it? These are the questions I ask when I think about the future of the stroke program at St. Luke’s Health-Memorial. We continue to invest in the program to ensure it always has the appropriate personnel, equipment, funding and support. After all, we’re committed to stroke care for the long term. We don’t want our program to remain in a steady state. Instead, we strive to constantly , but to continue to improve at every step of the way.

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