Sanford USD Medical Center Reaches the First Anniversary of Top Stroke Certification

One year ago, the Sanford USD Medical Center was named a Comprehensive Stroke Center by The Joint Commission. It remains the only hospital to have earned this top certification in South Dakota.

Divyajot Sandhu, MD, is a neuroendovascular physician at the Sanford USD Medical Center and has seen firsthand the certification’s impact on the community.

“Comprehensive Stroke Centers can handle any and all levels of complexity with stroke cases. You really can’t have any better or higher level of care than this,” Dr. Sandhu said.

To earn the designation, the Sanford USD Medical Center had to adhere to a long list of eligibility requirements. Comprehensive Stroke Centers must have a dedicated neuro-intensive care unit with specialists able to provide care 24/7 and establish outstanding stroke research and education programs.

For surgical stroke care, centers must have a cerebrovascular neurosurgery team able to manage brain vessel pathology of any difficulty with microsurgical and endovascular approaches.

Hospitals must prove a commitment to performance improvements and meet strict outcome criteria to keep the designation. They also need to care for a minimum number of patients every year with various treatments, including surgical and pharmaceutical interventions.

Patient outcomes and safety must be the number one priority of a Comprehensive Stroke Center.

“There have to be redundancies of redundancies of redundancies and fail-safes for fail-safes for fail-safes,” Dr. Sandhu said. “There can be no such thing as a failure of the system.”

When applying for the certification, Sanford Health leaders found the hospital was already meeting many of the stringent eligibility standards. One area the leaders increased focus on was specialized education for all staff. The certification requires that anyone who provides any level of care to a stroke patient needs to undergo extensive training.

“The training applies to everyone from bedside nurses to interventionalists to neurosurgeons – basically everyone a stroke patient comes in contact with. They all need to know how to care for patients with stroke needs,” Dr. Sandhu said. “That’s part of why we can provide better care than any hospital that isn’t a Comprehensive Stroke Center.”

Like all other aspects of the designation criteria, the education standards were demanding.

“It wasn’t just an online test that you could do at home with a glass of wine,” Dr. Sandhu said. “It required a lot of education and testing to be better prepared for neurovascular patients.”

Even after a hospital has met the eligibility criteria and completed thorough surveys, the designation is an ongoing process that requires a systematic review every two years. To remain a Comprehensive Stroke Center, hospitals must prove they have maintained or improved their standards and care for stroke patients.

“The certification does require quite a bit more work than we had to do before we were a Comprehensive Stroke Center,” said Dr. Sandhu. “But all of that work is worth it.”

The Joint Commission offers a range of stroke care designations, including several with less rigorous requirements than the Comprehensive Stroke Center certification. These lower designations are awarded to hospitals with dedicated stroke programs. However, they cannot care for certain complex cases, and while they have certain specialists on staff, they aren't available on-call 24/7.

For Comprehensive Stroke Centers or international locations that meet similar standards of care, pursuing the most advanced certification has its benefits.

“This certification isn’t just a plaque to hang on the wall. It has real results,” Dr. Sandhu said. “Numerous studies and patient analyses prove consistently across the board that patients in locations across the world that meet these standards do better. As in a several percentage point increase in the number of stroke patients who survive their stroke or the number of people who were discharged back home instead of to a nursing home.”

The Sanford USD Medical Center has seen these results in the last year.

“Because of the designation and the increase in the number of folks we can help, we have seen more patients do better than a year or two ago. It’s not just volume. We’ve had more people do better,” Dr. Sandhu said.

In addition to meeting the higher certification standards, the specialists at the Sanford USD Medical Center are holding themselves to higher standards.

“We’ve been keeping a much closer eye on ourselves and are harsher critics of ourselves than before,” Dr. Sandhu said. “And now we’re doing better than we ever were before.”

Sanford Health is proud to be the only location in the region to offer stroke care at this caliber.

“The closest Comprehensive Stroke Center would be Sanford Fargo. And then Minneapolis to the east and Omaha to the south. For the west, I think you’d have to hit Denver,” said Dr. Sandhu. “As far as stroke care is concerned, you can’t go anywhere better than here. There’s no need for a patient to travel.”