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UPDATED Emergency stroke patients to be sent off-Island

Submitted by on 1, November 30, 2010 – 7:40 pm5 Comments

Updated at 2:38 p.m. Tuesday, November 30

Emergency stroke victims who have traditionally been transported to Alameda Hospital will be sent elsewhere as of December 1, the hospital and Alameda County Emergency Medical Services department announced Monday evening.

Stroke victims who call 911 within the first four hours of developing symptoms will instead be whisked to one of the six Alameda County hospitals that have been accredited as stroke centers. The list includes Kaiser Permanente facilities in Oakland and Fremont, Alta Bates Summit Medical Centers in Oakland and Berkeley, Eden Medical Center in Castro Valley and Washington Hospital in Fremont.

“Alameda County considers this a temporary measure,” Alameda County Emergency Medical Services Director Dale Fanning was quoted as saying in a press release issued by the hospital. The release said the hospital is pursuing stroke center certification and that Fanning believes they will receive it within six months.

The hospital will continue to treat stroke patients who are not transported by ambulance or those who “are not identified by EMS policies as patients that will benefit from stroke center care,” the release said.

Alameda Hospital Chief Executive Officer Deborah Stebbins said that in 2007, the county gave Alameda Hospital an exemption from new rules that allowed it to receive ambulance-bound stroke patients who were within the critical four-hour window for receiving drug therapy in order to stabilize their symptoms. Stebbins said she didn’t know the rationale for the exemption, though she said some may have believed it better to transport the stroke patients to the closest hospital instead of taking them to a designated stroke center. Alameda is one of five hospitals in the county that don’t have stroke certification.

Emergency medical services officials did not respond to calls seeking comment Monday night or Tuesday.

Stebbins said county officials told the hospital last week that they would not maintain the exemption. But she said the hospital has been working toward obtaining certification and that she’s confident they will obtain it within six months. She said the hospital still needs to do some staff training and data collection in order to receive the certification, but that other needed elements are in place.

“We’ve done a lot of work with Eden (Medical Center) and adopted their protocols,” Stebbins said. She said she feels the hospital provides “responsible care” for stroke patients and that while hospital leadership is disappointed the county chose to end the hospital’s exemption, they understand why the decision was made.

She said the hospital will still get other stroke patients, including those who get to the hospital without the aid of an ambulance and others who are outside the four-hour window in which drugs that reduce the symptoms of stroke may be administered. The hospital has treated 375 stroke patients over the past two years, including those who came via ambulance and others who didn’t.

The county’s emergency medical service protocols became a source of controversy in October when resident Denise Lai wrote an op-ed piece in the Alameda Sun questioning the protocols and the quality of care at the hospital. The county protocols, which dictate where ambulance drivers take their patients, require ambulances in every city but Alameda to take emergency stroke patients to the closest stroke center. Alameda’s emergency stroke victims are to be taken to Alameda Hospital, the protocols say.

Alameda Health Care District Board president Jordan Battani replied in a letter to local media outlets in which she called such claims “inaccurate and misleading” and defended the care provided by the hospital.

“What’s distressing about these broad allegations of quality and safety failure is that they are not substantiated by the facts about processes and practices at the hospital,” Battani wrote. “Maintaining and promoting quality and safety for our patients is the most important job we have at Alameda Hospital.”

5 Comments »

  • Denise Lai says:

    Michelle: it's interesting how you make this very great thing sound like a bad thing. Starting tomorrow, City of Alameda residents and their visitors will get the type of care that the State of California outlines in our state stroke plan. It's NOT a bad thing for CVA victims to be taken off-island by ambulances! Being immediately taken off-island IS THE VERY THING that will extend our lives and protect our quality of life!!!

  • Michele_Ellson says:

    Hey Denise – thanks for your response. Do you have specific data or anecdotal information that supports concerns about bringing stroke patients to Alameda Hospital?

    • Denise Lai says:

      Sure. There are many documents detailing the urgent necessity of being transported directly into a certified stroke center–they are not hard to find. It's the reason the county was upgrading stroke protocols for every city in our county—I still do not understand how our hospital board and our county supervisor Alice Lai-Bitker allowed residents in the city of Alameda to suffer substandard protocols. I guess they think we are dummies. Please contact me if you'd like to interview me.

      Here's our California Master stroke and cardiac Plan: http://www.cdph.ca.gov/programs/cvd/Documents/CHD

  • JonSpangler says:

    It is good to know that Alameda Hospital will have the necessary CVA (stroke) certification in about 6 months. Then we can have the kind of care that Denise Lai claimed was lacking properly certified and approved, as it should be.

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