16 Del. Admin. Code § 4306-4.0
The following words and terms, when used in this regulation, have the following meaning:
"Acute Stroke Ready Hospital" or "ASRH" means a hospital or emergency center with a dedicated program for stroke care. It is the least comprehensive of the 4 stroke program certifications by The Joint Commission (TJC).
"Advanced Life Support" or "ALS" means a course of the AHA. Advanced Life Support refers to more advanced emergency medical response than Basic Life Support (BLS).
"American Heart Association" or "AHA" means a non-profit organization dedicated to fighting heart disease and stroke, including a division specifically for stroke prevention, education, and care. The American Heart Association maintains the Get With The Guidelines (GWTG) Stroke Registry.
"Basic Life Support" or "BLS" means entry-level emergency medical response as part of the prehospital triage scheme.
"Certification" means the process by which a healthcare facility petitions an organization to certify that their facility meets and maintains specified standards. For example, TJC certifies hospitals as stroke centers.
"Comprehensive Stroke Center" or "CSC" means the most extensive of TJC stroke program certifications. These centers maintain specific capabilities to be able to receive and care for the most complex stroke cases.
"Dedicated" means a resource used solely for a specific program.
"Department of Health and Social Services" or "DHSS" means a cabinet-level department that is comprised of several divisions that promote health and well-being for the citizens of Delaware.
"Designation" means a classification by which a hospital is identified by DHSS to have the appropriate resources to manage stroke patients with varying degrees of severity and is granted the authorization to function as a Delaware Stroke Center.
"Division of Public Health" or "DPH" means an agency under DHSS predominantly focused on physical health and well-being and emergency response and services.
"Emergency Medical Services" or "EMS" means the coordination of prehospital personnel, facilities, equipment, transportation, and communication to provide for the effective and coordinated delivery of medical care in emergencies resulting from accidents, illnesses, or natural disasters.
"Facility" means any location where healthcare is provided. May include stand-alone emergency departments, hospitals, skilled nursing, or rehabilitation.
"Get With the Guidelines Stroke Registry" or "GWTG" means an AHA created stroke patient registry and tool to evaluate performance indicators set by TJC.
"Hospital" means a licensed institution that provides diagnostic and therapeutic medical care. In Delaware, all stroke centers are in hospitals.
"Interfacility transfer" means the transfer of a patient from one healthcare facility to another healthcare facility.
"Large vessel occlusion" or "LVO" means the specific type of ischemic stroke where significant blockage of a major cerebral artery is present. LVOs often result in significant loss of blood flow, impact on higher level brain function, and less favorable outcomes.
"Performance improvement" means the continuous study and adaptation of the functions and processes of a healthcare organization to increase the probability of achieving desired outcomes and to better meet the needs of patients.
"Prevention" means the efforts to decrease the numbers and severity of strokes.
"Primary Stroke Centers" or "PSC" are the succeeding certification of stroke programs by TJC following ASRH. They provide critical elements such as additional diagnostics and designated bed space for stroke patients.
"Protocols" means written standards for clinical practice in a variety of situations within the Stroke System.
"Quality Evaluation Committee" or "QE Committee" means the subcommittee of the Stroke System Committee that provides recommendations, advice, and assistance to DPH in its ongoing evaluation of the Delaware Stroke System of Care. It evaluates data related to system metrics of success and quality of patient care and outcomes.
"Stroke" means a cerebrovascular accident caused by a change in blood flow that damages brain tissue. Typically caused by blood clots blocking perfusion in the brain (ischemic strokes and transient ischemic attacks) but can also be caused by non-traumatic subarachnoid or intracerebral bleeding (hemorrhagic strokes).
"Stroke System Committee" or "SSC" means the committee providing coordination, oversight, and guidance for all components of the Stroke System of Care in Delaware as established in Delaware code.
"The Joint Commission" or "TJC" means the national body that certifies or accredits various healthcare settings. The Joint Commission provides certification for stroke care centers.
"Thrombectomy-Capable Stroke Centers" or "TSC" means the third tier of TJC-certified stroke programs. In addition to the features and capabilities of ASRH and PSC, a TSC can provide endovascular procedures.
"Transfer agreement" means a formal written agreement between facilities that provides for the acceptance of patients in transfer.
"Triage" means the sorting of patients in terms of priority need for care so that appropriate treatment, transportation, and destination decisions can be made according to predetermined protocols.
"Vision, aphasia, neglect" or "VAN" means a prehospital stroke assessment tool focused on identifying LVOs. It considers motor function, visual disturbances, aphasia, and neglect (neglect evaluates senses and gaze). The assessment results in a VAN positive or VAN negative score. VAN positive indicates a high probability of an LVO.
"Verified" means successful completion of the process in which the stroke care capability and performance of an institution are evaluated by experienced on-site reviewers on behalf of TJC or other accrediting body.
16 Del. Admin. Code § 4306-4.0