IU Health Bloomington Hospital loses long held stroke certification - The Herald-Times

Indiana University Health Bloomington Hospital has lost a prestigious stroke certification, which tracks, among other things, the time it takes between a stroke patient's arrival and treatment.

An IU Health spokeswoman said via email the certification is voluntary, the hospital has other stroke certifications and it "continues to be a leading edge provider of stroke care."

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However, Dr. Ronnie Goswami, a Bloomington neurologist who formerly served as the hospital's medical director for the stroke neurology team, said the loss of the certification means some regional patients may have to be transferred to more advanced hospitals in Indianapolis.

Goswami, who left the health system about 18 months ago, said under his leadership, the local hospital retained the certification uninterrupted for more than a decade.

Goswami and his wife, Nancy Goswami, a nurse by training, also said they worry about what the loss of the certification may mean for the speed with which patients receive care, which is especially important for stroke patients, where minutes can mean the difference between life, disability and death.

Stroke is among the leading causes of death

A stroke occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. Stroke is among the leading causes of death, killing about 800,000 people in the U.S. every year. According to the Centers for Disease Control and Prevention, every 40 seconds, someone in the U.S. suffers a stroke, and every 3.5 minutes, someone dies of stroke.

Stroke is also a leading cause of serious long-term disability. Stroke reduces mobility in more than half of survivors aged 65 and older.

The certification the local hospital lost is given by The Joint Commission, a nonprofit that, according to its website, is the nation's "oldest and largest standards-setting and accrediting body in health care." The organization is governed by a 21-member board that includes educators, nurses and physicians.

The commission's associate director of communications, Katy Bronk, said health care organizations apply and have to pay a fee to get certified with "The Gold Seal of Approval."

The certification loss at IU Health Bloomington leaves local residents without proximity to an "advanced primary stroke center." The nearest hospitals with that certification are in Indianapolis. Twenty-three Indiana hospitals are certified as advanced primary stroke centers, according to the commission. Some are in communities with much smaller populations than Bloomington, including Valparaiso, La Porte and Warsaw, which has about 16,000 residents.

Doctor: Stroke patients may have to be taken elsewhere

Goswami said beyond speed of care, the lack of certification may mean some patients will have to be transferred, which brings its own set of problems, such as when transport vehicles are not available. Transfers by helicopter can be delayed by storms.

Goswami said the certification loss constitutes a blow to the facility's reputation because it can no longer market itself as having the commission's seal of approval for stroke care.

Samantha Kirby, senior public relations associate for IU Health, said via email the certification lapsed because the health system decided "to focus on the urgent needs of our patients and resources during the pandemic."

The Bloomington facility for 2022 did retain its Joint Commission certification for "Advanced Total Hip and Total Knee Replacement."

IU Health spokeswoman: Hospital 'committed to excellent stroke care'

Kirby said despite loss of the stroke certification, IU Health Bloomington remains "committed to excellent stroke care with or without this voluntary certification and continues to have the same high standards for our care."

She said the new Bloomington hospital holds other recognitions, including a Gold Plus Target Stroke Honor Roll Elite status with the American Heart Association and being rated "high performing" for strokes by U.S. News & World Report.

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The Joint Commission says on its website hospitals should pursue its certification for reasons including it creates a loyal, cohesive clinical team, provides a framework to improve patient outcomes and reduces the risk of error.

Goswami said during his time at the hospital, his team had to track and comply with measures such as the speed with which care was provided and follow up to make sure patients performed their physical therapy and took their medications to prevent recurrences and readmissions.

"These are very critical to the patient," he said.

Goswami said at the height of the local stroke care program, it had three full-time neurologists at the hospital and three who were contracted.

Kirby said in the email the hospital now has a team of five neurologists, compared to three neurologists and two physicians in 2017.

IU Health Bloomington has a job opening on its website for a general outpatient neurologist. The posting reads that procedures to be performed include diagnostics and Botox injections.

The commission says on its website certifications enhance a facility's ability "to attract top-level talent."

IU Health Bloomington moved into a new $557 million facility in December. Its parent organization, also a nonprofit, generated more than $1 billion in profit last year, excluding a $16 million gift the organization made to the School of Nursing at IUPUI and a $400 million gift to Indiana University's School of Medicine. IRS tax records show IU Health Bloomington hospital between 2018 and 2020 generated profit exceeding $300 million.

Kirby said IU Health "is evaluating the re-certification with the Joint Commission as we continually evaluate the benefit of any certification to our patients."

Stroke prevention

The CDC says you can help prevent stroke by making healthy choices:

• Choose healthy foods and drinks, such as fresh fruits and vegetables.
• Keep a healthy weight.
• Get regular physical activity. The U.S. Surgeon General recommends 2.5 hours of moderate-intensity aerobic physical activity, such as a brisk walk, each week. Children and teens should get one hour of physical activity every day.
• Don't smoke. Cigarette smoking greatly increases your chances of having a stroke. If you don't smoke, don't start. If you do smoke, quitting will lower your risk for stroke.
• Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than two drinks per day, and women should have no more than one per day.
• Control your medical conditions. If you have heart disease, high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for stroke.
• Have a doctor check your cholesterol at least once every five years.
• Have a doctor check your blood pressure.
• Have a doctor check you for diabetes.
• Treat your heart conditions. Taking care of heart problems can help prevent stroke.
• If you take medicine to treat heart disease, high cholesterol, high blood pressure, or diabetes, follow your doctor's instructions carefully.
• Work with your health care team. You and your health care team can work together to prevent or treat the medical conditions that lead to stroke.