Neurologist teams up with hospital staff to build stroke program with great results
Dr. Arun Talkad, medical director of Primary Stroke Center, Palm Beach Gardens Medical Center
The opening of Palm Beach Gardens Medical Center’s Primary Stroke Center offered life-altering services to the entire community and a new opportunity for neurologist, Dr. Arun Talkad.
“I wanted to help the hospital build the stroke program, and I had excellent support to grow something here,” says Dr. Talkad. “The pieces were in place—the ER is phenomenal—so they just needed someone to put it all together.”
While the Primary Stroke Center may still be in its early days, it’s growing at a much faster rate than Dr. Talkad expected, thanks to an enthusiastic and cooperative team effort.
“Within two or three months after I arrived, we were already at the level I thought would take 12 to 18 months,” he says. “With the help of the ER and administrative staff, we progressed much more quickly than expected. I knew the ER, hospital and nursing staff were all eager to advance, but I hadn’t expected it to go so smoothly.”
Delivering acute stroke care
The Primary Stroke Center is a unit dedicated to providing acute stroke care to the community. Acute stroke care starts with and centers on timely evaluation in the emergency department. Optimal outcomes require a coordinated effort between the ER, neurology and radiology to diagnose patients quickly and determine whether they need the clot-busting drug, tissue plasminogen activator (tPA), the only FDA-approved therapy for stroke.
“We have to give tPA within three hours of when symptoms begin. The national standard is within 60 minutes of walking into the hospital, and the national average is about 66 minutes. Our average door-to-needle time was 65 minutes, but within about three months, that average dropped to 35 minutes,” says Dr. Talkad. “The ability to rapidly diagnose someone, get the CT scans and testing completed, and administer the drug are all core measures of what an acute stroke program should be.”
Where we go from here
Building upon the Stroke Center’s solid foundation, Dr. Talkad now envisions receiving more volume and managing more complex cases.
“Now that we’ve cemented and affirmed our processes, it’s a matter of going to EMS and the public and educating them on how to deal with stroke and to illustrate our expertise. Growth goes from expanding volume to the complexity of cases. We’re already seeing more complex cases than we previously saw,” he says.
Dr. Talkad came to Palm Beach Gardens from an academic institution and has been impressed by the level of technology, commitment and ability to handle complicated neurological cases that he’s seen at Palm Beach Gardens Medical Center.
“The strongest attribute of this hospital when I arrived was a commitment to peak performance among the administration and nursing staff. Even though this is a community hospital, the population is complex, and we aren’t just seeing simple cases,” notes Dr. Talkad. “This hospital was already equipped to handle it and just needed some added neurological guidance. That was my advantage in being able to progress so quickly.”