DOWNEY - Rancho Los Amigos National Rehabilitation Center has won a major statewide award for its groundbreaking work in improving the quality of stroke care in the Los Angeles County safety net system.Rancho's Acute Stroke Unit, headed by Amytis Towfighi, MD, was honored with the Kaiser Permanente Clinical Systems Development Award at the 2011 Annual Conference of the California Association of Public Hospitals and Health Systems, held earlier this month in San Jose. Rancho's Acute Stroke Unit was created just four years ago. Today it has become the primary site for patients with stroke and transient aschemic attack (TIA) in the Los Angeles County healthcare system. "This is one of many innovative Rancho programs that provide very high-quality services for our patients," said Rancho Chief Executive Officer Jorge Orozco. "Today our stroke patients are getting cutting-edge care and returning home faster than those at other hospitals. "Stroke is the most common diagnosis requiring rehabilitation at Rancho, and so it is especially important that we provide these patients the quickest, most efficient access to testing, medication and therapy," Jorge said. "We are very proud of the program Dr. Towfighi has created at Rancho, and we salute her and her team for what they are accomplishing for our patients each and every day." Dr. Towfighi created a comprehensive array of protocols for the stroke unit based on the best practices in stroke care and research findings. "We provide all the diagnostic studies necessary to determine why our patients had their stroke, and at the same time they are getting the care they need to prevent the stroke from expanding and to prevent recurrent strokes," Dr. Towfighi said. "Many of our patients had not previously had any access to healthcare, and so they didn't know they had a diagnosis of high blood pressure or diabetes or abnormal cholesterol before coming to Rancho. So we educate our patients and start them on medications to reduce their risk of a future stroke." Rancho's Chief Medical Officer, Mindy Aisen, MD put the program into perspective: "This model is the first of its kind in our country, and it is very exciting. By moving people through the acute care process more quickly, they get to rehab more quickly. And the quicker you get up on your feet and begin practicing movement, the more quickly your brain is going to reorganize and you regain motor function. "We move people through acute care, get them active as quickly as possible, and get them the tools they need to go home and continue to improve throughout the life span without having the complications of stroke or an additional stroke," she said. In partnership with other Los Angeles County Department of Health Services public hospitals, patients coming to emergency departments with TIA or stroke are immediately transferred to Rancho to receive care by a multidisciplinary team. The team includes a board-certified vascular neurologist, specialized nurses, therapists, case managers, and social workers. At Rancho, patients receive a thorough and efficient diagnostic evaluation, therapies, secondary stroke prevention, early intensive rehabilitation, education on stroke risk factor control and prevention, information regarding local stroke survivor support groups, home blood pressure monitoring devices to assist in self-management, and outpatient follow-up at 30 days. Patients are then smoothly transitioned to either inpatient or outpatient rehabilitation. "Having an acute stroke unit at Rancho makes much better use of county resources and provides much better care for the patients," said Helena Chui, MD, Chair of USC's Department of Neurology. "It is amazing to see that in just four years from its inception, Rancho's acute stroke unit now treats more stroke patients than any hospital in the county." "We provide all of our patients with medications as outpatients, and we follow-up with them in our stroke clinic at 7 days and 30 days," Dr. Towfighi said. "We were also able to secure funding from the Kaiser Permanente Community Benefit Program to track all of our outcomes in a database that tracks patients admitted to the stroke unit to assure they receive the quality care they deserve." Rancho provides each stroke patient with a binder in English or Spanish with educational materials about stroke. "It's great when I see them come back to our clinic and they have their binder and they've read it," said Rancho neurologist Susan Shaw, MD. "Maybe they have questions or they're keeping a log of their blood pressure in the binder. It's a great way for them to better organize their care and become better advocates for themselves." "We've had excellent results with our program," said Dr. Towfighi. "Prior to the development of our unit, the average length of stay at other County hospitals for strokes was 8 to 9 days. The length of stay in our unit is only two to three days, so patients are returning home sooner and in better health. Given the fantastic results of our unit, we will soon be publishing our results." The project is now expanding to create a Patient-Centered Medical Home for stroke to ensure that patients with TIA or stroke adhere to secondary stroke prevention medications and a healthy lifestyle. "At Rancho, we are transforming the delivery of care for our stroke patients," Jorge said. "This major award is just the latest indication of how Rancho makes a huge difference for our patients. As we enter our 125th year of service, Rancho continues to lead the way in the art and science of rehabilitation medicine." For further information, call the Rancho Los Amigos Foundation at (562) 401-7053 or visit rancho.org, facebook.com/rancholosamigosrehab or twitter.com/ranchorehab.
********** Published: December 22, 2011 - Volume 10 - Issue 36