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To achieve the Get With The Guidelines-Stroke Gold Plus Performance Achievement Award, and also gain a place on the Target: Stroke Honor Roll, is no small feat. The awards are sponsored by the American Heart Association/American Stroke Association (AHA/ASA), and only one out of nine New York City hospitals received each for 2012. To attain the accolades, a hospital's stroke program must meet stringent quality measures, and demonstrate an ability to provide cutting-edge stroke treatment within narrow windows of time. New York Methodist Hospital has just received both of those awards for 2012. "These honors demonstrate that we have top level stroke care at NYM," said Barbara Gatton, MD, director of quality assurance for the Department of Emergency Medicine.

The core requirement for the Target: Stroke Honor Roll is the rapid application of intravenous tissue plasmogen activator (tPA), a clot-busting protein that can often reverse the debilitating effects of ischemic strokes (strokes that occur due to a blocked artery in the brain). "To be placed on the Honor Roll, you have to consistently administer tPA within an hour of the patient's arrival at the Hospital," said Joseph Bove, MD, chairman of emergency medicine, "and before you administer tPA, a lot has to happen. You need to identify who is having a stroke; you need to get a CT scan performed and read; you need to have blood samples taken and analyzed; you need to have a neurologist thoroughly examine the patient; and all of it has to happen with great care and caution."

When tPA administration isn't enough to reverse an ischemic stroke, NYM has advanced treatment options. In cases where interventional care is needed, Michael Ayad, MD, neurosurgeon and neurointerventionalist, is at the ready to perform minimally invasive procedures that can neutralize ischemic strokes. "During a stroke, two million neurons die every minute," said Dr. Ayad. "Obviously, time is of the essence."

However, the first few hours aren't the only critical part of stroke care. To receive the Gold Plus Award, NYM demonstrated an ability to provide the highest quality stroke care across multiple stages of stroke treatment, from the acute phase to discharge. Steven Silber, D.O., vice president for medical affairs and chairman of the Neurological Emergencies Committee, helped establish NYM's Stroke Center almost 10 years ago, and is well suited to put the awards in perspective. "What I'm proudest of is the stroke program's incredible teamwork and camaraderie, from the EMS, to the clerks, physician assistants, dedicated nurses, radiologists, neurologists, and all of the other physicians and staff members that play a role. It's a phenomenal group of people."