Statewide UAMS IDHI Stroke Program Hits Record Benchmarks for Care
| Over the last 17 years, the UAMS IDHI Stroke Program has helped dramatically reshape the quality of stroke care in Arkansas. More than three-quarters of the state’s hospitals now rely on UAMS’ digital health network for 24/7 consults with stroke neurologists. As it has grown, the program has continued to streamline its stroke care and education to improve outcomes.
Joseph Sanford, M.D., credited the program for its greater impact on stroke-related disability.Bryan Clifton
This past year, the program, a part of the UAMS Institute for Digital Health & Innovation, broke records across the board, receiving more consults, treating more patients and achieving faster benchmarks that significantly improve stroke survivability.
“The success of the stroke program is measured not only in record-setting performance metrics but in its broader impact, delivering top-tier care across our partner sites and sparing patients and the state the lasting human and economic toll of stroke-related disability,” said Joseph Sanford, M.D., director of the UAMS Institute for Digital Health & Innovation.
The UAMS IDHI Stroke Program is a statewide initiative that digitally connects 64 hospitals across Arkansas with stroke specialists, enabling local providers with rapid evaluation and treatment of stroke patients. The program has four vascular neurologists on call around the clock to provide live video consultations. It also provides education to citizens and first responders alike on the signs and symptoms of stroke.
Not all hospitals have stroke neurologists on staff, but thanks to the UAMS IDHI Stroke Program, providers at partner hospitals can speak with one at any time, day or night. Timely treatment is essential to saving lives and preventing debilitating injury for stroke patients, who must be evaluated and treated within the crucial 4.5-hour period following the first signs of stroke.
Stroke is the fourth-leading cause of death in the United States. When the UAMS IDHI Stroke Program started in 2008, Arkansas had the highest number of stroke deaths per capita in the U.S. Now, Arkansas has the fourth lowest rates of stroke deaths per capita, behind only Delaware, Mississippi and Alabama, based on data from the Centers for Disease Control and Prevention.
Record Consults and Exceeding National Metrics
The UAMS IDHI Stroke Program has helped save the lives of thousands of Arkansans and preserve quality of life, said Lori Berry, MNSc, RN, the program’s director of operations.
“Our program is unique — it’s a public program that belongs to the citizens of Arkansas,” Berry said. “It saves lives, gets stroke patients back on their feet and lessens the burden of stroke care to the state. But more importantly, it provides hope and relief to patients and families who may otherwise suffer under the burden of long-term disability without treatment for stroke.”
Patient outcomes continue to improve, even as the program adds more partner hospitals.
Lori Berry, MNSc, RN, said that the program has helped save the lives of thousands of Arkansans.Evan Lewis
Last year, the program reached a record number of consults at 2,141 and in patients treated at 775, Berry said. Of those patients, 62% were discharged home, well ahead of the 50% national average. Additionally, 83% of patients also regained ambulatory status, or the ability to walk and function independently — significantly higher than the national average of only 53%.
The UAMS IDHI Stroke Program also continues to drive down its average door-to-needle time, or the time from patient arrival at the hospital to delivery of clot-busting medication. Clinical guidelines advise an optimal median door-to-needle time of 60 minutes. Over the past five years, the program has met or exceeded that number and now averages 50 minutes, Berry said. Education for first responders has also shaved 10 minutes off their average for necessary computed tomography or CT scans, from 18 minutes to eight.
“Ten minutes may not seem like much, but it can save a life,” Berry said. “It’s huge.”
State Hospitals Thriving Under Program
Faster response times translate to better outcomes, which benefit not only patients but hospitals as well. Saint Mary’s Regional Health System in Russellville and St. Bernards Medical Center in Jonesboro and are two hospitals that have thrived under the UAMS Stroke Program. Saint Mary’s joined the program in 2010 and St. Bernards joined in 2019.
Tim Tanner, BSN, RN, said the difference since Saint Mary’s joined the program in 2010 “is daylight and dark.”Saint Mary's
Saint Mary’s now averages 37 minutes in door-to-needle time, a large drop from its 85-minute average 10 years ago. Earlier this year, one session was as short as 17 minutes. That’s great news for patients, said Tim Tanner, BSN, RN, the hospital’s stroke facilitator and ER nurse manager.
“Our door-to-needle times since 2010 have dropped drastically,” Tanner said. “The difference in before and after is daylight and dark, and it just keeps getting better.”
The UAMS IDHI Stroke Program was created around the same time as major advances in clot-busting medication, and Saint Mary’s was one of the program’s early adopters. Tanner said partnering with the program has given them invaluable “backup” to treat stroke patients.
“I always tell people I’m very proud to be part of this program and for our hospital to be part of it because as far as I know, it’s the only one like it in the nation,” said Tanner. “The support they’ve given us, not only on the emergency end of it but also the inpatient side of it, has been tremendous. It’s just been an awesome program. We’ve got other states looking at us, saying how are y’all doing this?”
Joanne Sullivan, RN, and Brittney Yancy, RN, coordinate stroke care for St. Bernards. As a regional hub that sees patients from all over Northeast Arkansas, as well as parts of Missouri, having more resources allows them to coordinate stroke care across shifts, they said.
“The education that they’ve provided has been key,” Sullivan said. “Our door-to-needle time, we’ve improved substantially on those times because we’re using the program effectively now, and we have the resources that they provide us for staff and community education.”
“We have a lot of resources, but having UAMS as a resource is awesome,” Yancy added.
Brittney Yancy, RN (center) with staff from St. Bernards Medical Center at a UAMS stroke conference in 2023.St. Bernards
Since joining the UAMS IDHI Stroke Program, St. Bernards has reduced its door-to-needle time year-by-year, dropping its peak average of 81 minutes down by half, to 41 minutes. Its fastest time so far is 18 minutes. Sullivan added that having those metrics is key to improving care.
“Part of what the program has helped us do is fine-tune our skills to where we’re doing things efficiently,” Sullivan said. “It’s very data-driven. We’ve got good data to work with because we’ve got consistent processes in place thanks to IDHI, who has provided us with a structure that all of the hospitals in this state can use and feel comfortable using.”
The comfort level that St. Bernards has with the program is something nurses literally carry with them. Yancy, who coordinates stroke care from the ER, advises her nurses to add the program as a contact in their cell phones for when they need it.
“It’s just a phone call away,” Yancy said. “That’s what I tell my nurses: save that number in your cell phone. Treat it like your boyfriend or your husband or your kid, and when a stroke patient comes in, call it.”