Page 5 - Hoag Neurosciences Institute Annual Report
P. 5






stRoKe PRogRAM




Hoag’s cutting-edge stroke program is led by also implemented a “Code 20” Stroke Protocol that 
full-time, in-house physicians who specialize
sets in motion an eficient, fast-paced team to care

in advanced stroke management and intervention, for stroke patients. Hoag beats the national average 
and have developed best practice guidelines to by 10 minutes, saving 20 million brain cells. Hoag 

provide the best possible outcomes. As a designated has dramatically increased the rate at which IV tPA 

Comprehensive Stroke Neurology Receiving Center, is administered to eligible acute ischemic stroke 
Hoag pioneered specialized approaches that have patients – up from 2% a decade ago to 15% currently. 

been shown to provide the best possible outcomes This rate triples the national average of 5%. Ninety- 
for stroke patients. These methods require early day outcomes are available for all patients, 58% 

identiication of stroke and immediate care by stroke achieving a self-suficient lifestyle. This is signiicantly 
experts. Stroke patients are immediately evaluated
better than the literature reported outcomes.

in the emergency department and triaged for the 
team
most rapid and advanced treatment appropriate to 
the patient’s condition. As part of the stroke team, Hoag’s Stroke Program is led by David Brown, M.D., 

Hoag’s emergency department physicians and staff a neurologist with a specialty in stroke and cerebro- 
are well trained and understand how important it is vascular disease and a neurohospitalist. As the 

to follow the Stroke Protocol; a Code 20 is part of Program Director of the program, he has developed 
that process. In place since January 2008, Code 20 
a dedicated, multi-disciplinary acute stroke response 
provides the patients arriving at Hoag’s emergency team that provides immediate care to stroke patients 

department presenting with signs of stroke with
throughout the hospital and meets regularly for 
an initial triage assessment, lab testing, and neuro process improvement. The nurse navigator for the 

imaging within 20 minutes of their arrival; surpassing program is Deb Mastrolia, RN. Deb is certiied
the national suggested benchmark of 30 minutes. with the American Board of Neuroscience Nursing 

Evidence based use of clot-busting treatments with for both Neuroscience nursing – CNRN and Stroke 

intravenous thrombolytic therapy and endovascular nursing – SCRN along with the American Association 
intervention when needed optimizes the chances for of Critical Care nursing – CCRN specialty. She has 

stroke reversal.
worked with Dr. Brown to help develop and certify
a multidisciplinary stroke team. She also consults for 
Patients are then cared for in the hospital’s Neuro 
Intensive Care Unit and the 12-bed Stroke Unit.
Stroke certifying agencies.

All stages of care are staffed with nurses experienced 

in the diagnosis, treatment, and complications
of a stroke, and who have extensive training in the 

appropriate care of such patients. Program highlights 
include a ranking in the top 5% in the nation for stroke 

care by Healthgrades®. Hoag has been awarded the 
Stroke Gold PLUS Performance Achievement Award 

by the American Stroke Association for four years

in a row. Hoag also worked with the Orange County 
Health Care Agency to develop the comprehensive 

Stroke Neurology Receiving Center system and
has the SNRC designation. Hoag is the only hospital

in Orange County to have in-house, dedicated 
neuro-hospitalists working together with world- 

renowned neuro-interventionalists to immediately 

respond to neurological emergencies. Hoag has










stroke Program: 949-764-1454


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