Section 100270.226 - Acute Stroke Ready Hospitals(a) Hospitals designated by the local EMS agency as an acute stroke ready hospital shall meet all the following minimum criteria: (1) A clinical stroke team available to see, in person or via telehealth, a patient identified as a potential acute stroke patient within twenty (20) minutes following the patient's arrival at the hospital's emergency department.(2) Written policies and procedures for emergency department stroke services that are reviewed, revised as needed, and implemented at least every three (3) years.(3) Emergency department policies and procedures shall include written protocols and standardized orders for the emergency care of stroke patients.(4) Data-driven, continuous quality improvement process including collection and monitoring of standardized performance measures.(5) Neuro-imaging services capability that is available twenty-four (24) hours a day, seven (7) days a week, three hundred and sixty-five (365) days per year, such that imaging shall be performed and reviewed by a physician within forty-five (45) minutes following emergency department arrival.(6) Neuro-imaging services shall, at a minimum, include CT or MRI, or both.(7) Interpretation of the imaging. (A) If teleradiology is used in image interpretation, all staffing and staff qualification requirements contained in this section shall remain in effect and shall be documented by the hospital.(B) Neuro-imaging studies shall be reviewed by a physician with appropriate expertise, such as a board-certified radiologist, board-certified neurologist, a board-certified neurosurgeon, or residents who interpret such studies as part of their training in ACGME-approved radiology, neurology, or neurosurgery training program within forty-five (45) minutes of emergency department arrival. (i) For the purpose of this subsection, a qualified radiologist shall be board-certified by the American Board of Radiology or the American Osteopathic Board of Radiology.(ii) For the purpose of this subsection, a qualified neurologist shall be board-certified by the American Board of Psychiatry and Neurology or the American Osteopathic Board of Neurology and Psychiatry.(iii) For the purpose of this subsection, a qualified neurosurgeon shall be board-certified by the American Board of Neurological Surgery.(8) Laboratory services shall, at a minimum, include blood testing, electrocardiography and x-ray services, and be available twenty-four (24) hours a day, seven (7) days a week, three hundred and sixty-five (365) days per year, and able to be completed and reviewed by physician within sixty (60) minutes following emergency department arrival.(9) Neurosurgical services shall be available, including operating room availability, either directly or under an agreement with a thrombecotomy-capable, primary or comprehensive stroke center, within three (3) hours following the arrival of acute stroke patients to an acute stroke-ready hospital.(10) Provide IV thrombolytic treatment and have transfer arrangements with one or more thrombectomy-capable, primary or comprehensive stroke center(s) that facilitate the transfer of patients with strokes to the stroke center(s) for care when clinically warranted.(11) There shall be a medical director of an acute stroke-ready hospital, who may also serve as a member of a stroke team, who is a physician or advanced practice nurse who maintains at least four (4) hours per year of educational time in cerebrovascular disease;(12) Clinical stroke team for an acute stroke-ready hospital at a minimum shall consist of a nurse and a physician with training and expertise in acute stroke care.(b) Additional requirements may be stipulated by the local EMS agency medical director.Cal. Code Regs. Tit. 22, § 100270.226
1. New section filed 4-17-2019; operative 7-1-2019 (Register 2019, No. 16). Note: Authority cited: Sections 1797.107, 1797.176 and 1798.150, Health and Safety Code. Reference: Sections 1797.103, 1797.204, 1797.220, 1797.222 and 1798.172, Health and Safety Code.
1. New section filed 4-17-2019; operative 7/1/2019 (Register 2019, No. 16).