Op-Ed on the Texas Stroke Act
The following is an op-ed piece by State Senator Robert F. Deuell, M.D. (R-Greenville) and James Grotta, M.D. Professor of Neurology, University of Texas-Houston Medical School Director of Stroke Program, Memorial Hermann Hospital, Houston Chair, Stroke (TexAS) Force
Imagine waking up tomorrow morning, and not being able to speak or take care of yourself. You are unable to communicate with your spouse, children and friends. Simple tasks like driving, dressing yourself and walking are difficult or impossible. Imagine all of these skills suddenly gone, with no warning.
You have had a stroke, and in addition to your routine daily activities, perhaps a piece of your dignity has been taken from you. Your life has changed drastically - that is, if you survived. For close to 70,000 Texans each year, this is their reality.
A stroke is a blockage of blood flow to the brain, the result of either a clogged or ruptured blood vessel. Stroke is not only the No. 3 cause of death in Texas, but also the leading cause of serious long-term disability in Texas. Stroke survivors experience paralysis, muscle weakness, difficulty speaking and swallowing, blindness and memory loss.
In addition to the terrible toll strokes take on individuals and their families, strokes place a huge financial burden on our state and nation. In 2002, hospital charges in Texas totaled more than $1.5 billion, with about two-thirds of those charges being paid by Medicaid and Medicare. Strokes cost Americans more than $51 billion annually, in both medical expenses and lost productivity. The taxpayers are the ones who pick up the tab for these and many ongoing expenses related to necessary rehabilitation and nursing home costs.
Receiving timely emergency care is absolutely critical to stroke survival and recovery. Earlier this week, State Sen. Robert Deuell filed Senate Bill 330, the Texas Stroke Act.
The Texas Stroke Act will encourage the creation and designation of primary stroke centers, dedicated hospital units that have the available resources, personnel and equipment to effectively diagnose, evaluate and treat strokes and any associated complications 24 hours a day. Stroke facilities should be designated in accordance with national standards approved by the Joint Commission on Accredited Healthcare Organizations (JCAHO). Considered the "gold standard" of stroke care, JCAHO evaluates stroke care provided by hospitals using criteria developed in conjunction with the American Stroke Association. Memorial Hermann Hospital in Houston is one of the first hospitals in Texas to receive JCAHO certification, and the stroke team looks forward to continuing to offer consistent, quality care to stroke patients.
In addition, the Texas Stroke Act will strengthen local emergency triage and EMS training. Once a hospital receives JCAHO certification, the local EMS Regional Advisory Council chair should develop a stroke triage plan that includes treatment and transportation protocols. Training certification and continuing education requirements should be enhanced for EMS personnel regarding stroke treatment procedures.
The American public does not recognize stroke as an acute emergency event, and this lack of awareness presents a major obstacle to fighting stroke, disability and death. Upon experiencing stroke warning signs, taking immediate action is critical. For instance, if given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke. In addition, controlling high blood pressure and cholesterol levels, not smoking, regular physical activity and controlling diabetes can help reduce an individual's risk of stroke. To increase public awareness of stroke risk factors and prevention, warning signs, diagnosis and treatment, the Texas Stroke Act encourages the creation of a public awareness and education campaign.
A grants program to help provide incentives to hospitals to become primary stroke centers is included in the Texas Stroke Act. The Rural/Underserved Needs Grant will support hospitals in rural areas seeking JCAHO certification. In addition, the Primary Stroke Center Grant will provide resources to hospitals preparing to pursue certification and will encourage the mentoring of other hospitals.
Prevention, detection and quality care are key weapons to be used in the fight against stroke in Texas, and the Texas Stroke Act would go a long way toward achieving these goals. Training medical professionals on how to best treat stroke victims and educating the public about the importance of preventing and recognizing stroke will reduce deaths and improve outcomes for stroke victims across the state.
Chances are, you or someone you love has had a stroke. If not, consider yourself fortunate. Let's hope that, if that day comes, you have access to rapid response and the best in stroke care that the Texas Stroke Act seeks to provide.