May 28, 2009

Every Certified Legal Nurse Consultant knows that after a patient has a stroke, the care they receive in the first 3-4 hours is the most crucial. The type of stroke influences the treatment so proper recognition and diagnosis are essential. Despite this knowledge, the National Quality Forum (NQF) recently rejected a proposed guideline that would have called for a CT scan within 45 minutes of a patient presenting to the ED. Why is this important? The NQF sets the medical guidelines that are used by the Centers for Medicare & Medicaid Services (CMS) to evaluate (and reimburse) hospitals. So, with no reimbursement, the likelihood of a patient getting a CT scan drops pretty dramatically.

Hospitals receiving Medicare funding will soon be reporting how well they comply with guidelines for stroke treatment, even though one of the most important diagnostic tools for stroke (a CT scan) was not done.

The American Association of Neurology pushed strongly for the guideline and the American Stroke Association’s (ASA) guidelines for stroke care include the recommended 45-minute standard for scans. According to the ASA nearly 700,000 Americans incur a stroke annually, with 170,000 fatalities. In other words, an American suffers a stroke every 45 seconds and every 3 minutes, one of these stroke victims dies, so it’s very likely you’ll run into a case involving a stroke at some point in your legal nurse consulting career. As a CLNC^® consultant working on stroke cases, you should establish whether the standards of care for diagnosing and treating stroke were adhered to by the potential defendant hospital and healthcare providers. Establish not only whether or not a CT scan was done, but how timely it was ordered, completed and interpreted. Despite NQF, who looks like they had a stroke (not a stroke of genius) reputable testifying experts will be testifying in medical malpractice cases that a CT scan within 45 minutes of presenting to the ED is the standard of care.

Success Is Inside!

P.S.     Comment and share your vote on NQF’s decision.