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Hospital Name:
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1) Your hospital is:
Public
Private
Public and Private
Other
 
2) Number of beds in the hospital
 
3) Number of strokes in 1 year
 
4) Good internet conexion
No         Yes
 
5) Eletronic Records
Does your hospital use electronic records?
No         Yes
 
6) SITS-QR/RES-Q
Is your hospital using SITS-QR or RES-Q registries?
No         Yes, RES-Q         Yes, SITS-QR        
 
7) Other Registry?
Is your hospital using other quality indicators registry for stroke? (no SITS-QR or RES-Q)

No
Yes, a hospital registry
Yes, a national registry
Other
 
8) Does your hospital have a heart-brain integration program?
A program that integrates neurologists and cardiologists for case discussions, teams, protocols
No         Yes
 
9) Does your stroke team include a cardiologist?
No         Yes
 
10) Does your stroke team conduct neuro-cardiology rounds?
No         Yes
 
11) Does your hospital participate in the Brain & Heart Global Initiative program (WSO BEAT)?
No         Yes
 
12) Does your hospital have emergency services?
No         Yes
 
13) If there is an emergency department, is it open 24h a day, 7 days a week?
No         Yes
 
ACCESS TO BASIC DIAGNOSIS SERVICES
Which one(s) of the following are available in your hospital?
 
14) Does your hospital have its own laboratory for blood tests?
No         Yes
 
15) Laboratory blood test 24/7
Complete blood count, electrolytes, urea, glucose, INR, PT available 24 hours a day, 7 days a week?
No         Yes
 
16) Eletrocardiogram in the hospital
No         Yes
 
17) Electrocardiogram 24/7
Electrocardiogram (12 lead) available 24 hours a day, 7 days a week
No         Yes
 
18) Does your hospital have CT scanner?
No         Yes
 
19) Computed Tomography 24/7
Computed Tomography (CT) brain scan in the hospital (on site) available 24 hours/day, 7 days/week
No         Yes
 
20) CTA capability?
capability to do computer Tomography Angiography (CTA) in the hospital (on site)
No         Yes
 
21) CTA capability 24/7
capability to do Computed Tomography Angiography (CTA) in the hospital (on site) 24h/7 days
No         Yes
 
22) Transthoracic Echocardiography
Echocardiography is available in your hospital?
No         Yes
 
23) Vascular Doppler ultrasound
Extracranial Doppler ultrasound is available in your hospital?
No         Yes
 
24) Holter monitors
Prolonged ECG monitoring devices (Holter monitors) are available in your hospital?
No         Yes
 
ADVANCED DIAGNOSTIC SERVICES
 
25) Magnetic Resonance Imaging (MRI)
Is access to MRI available?
No         Yes
 
26) MR Angiography
Access to MRA is available in your hospital?
No         Yes
 
27) CT or MR Perfusion scans
CT or MR perfusion are available in your hospital (on site)?
No         Yes
 
28) Prolonged EKG monitoring devices
Are long-term monitoring EKG devices available at your hospital?
No         Yes
 
29) Transcranial Doppler
Transcranial Doppler is available in your hospital?
No         Yes
 
30) Transesophageal Echocardiogram
Transesophageal Echocardiogram is available at your hospital?
No         Yes
 
31) ACCESS TO HYPERACUTE STROKE CARE 24/7
Are there protocols for rapid evaluation and diagnosis of stroke patients in Hospital/Emergency department 24hours/day, 7days/week, with time metrics assessment?
No         Yes
 
32) IV thrombolysis
Access to IV thrombolysis
No         Yes
 
33) Thrombolysis 24/7
Access to IV thrombolysis 24h/day, 7days/week
No         Yes
 
34) STROKE SPECIALISTS FOR THROMBOLYSIS
Check below the specialist responsible for THROMBOLYSIS treatment in your hospital (check all available):

Neurologist
Neurosurgeon
Emergency physician
Intensivists
Other speciality
Access to stroke specialists through telestroke modalities, and teleradiology
 
35) Number of IV thrombolysis in 1 year
if not available, please answer 0 (zero)
 
36) ACCESS TO AMBULANCE
Is there access to emergency medical services (EMS - ambulance)?
No         Yes
 
37) Ambulance type
Public Private Both NA
Public
Private
Both
NA
 
38) Ambulance - training
Training of ambulance crews to identify stroke signs using FAST mnemonic or similar
No         Yes
 
39) Ambulance - priority for stroke
Work with ambulance systems to have stroke identified as a high priority transport emergency
No         Yes
 
NURSING AVAILABILITY
Access to nurses and nursing assessment with stroke training
 
40) Nursing assessment acute care settings
Access to nurses and nursing assessment with stroke training in acute care (the training should be documented, at least 4 hours/year - the documentation can be uploaded in the platform or should be presented during the onsite visit)
No         Yes
 
41) Stroke Nurses in Stroke Unit
Stroke unit settings (the training should be documented, at least 4 hours/year - the documentation can be uploaded in the platform or should be presented during the onsite visit, including stroke unit protocols, neurological assessment and swallow screen)
No         Yes
 
42) PROGRAM TO DEVELOP COMPETENCIES
Is there a program to develop and maintain core competencies in stroke care?
No         Yes
 
43) ACCESS TO ANY STROKE UNIT
Access to inpatient stroke care in ANY stroke unit (exclusive or clustered)
No         Yes
 
44) Stroke Unit Exclusive
A defined group of beds, staff, and protocols that are used for the stroke care
No         Yes
 
45) Clustered stroke unit
Access to a clustered model of stroke unit on same ward
No         Yes
 
INTERDISCIPLINARY STROKE TEAM
Are there members of an interdisciplinary stroke team?
 
46) Neurologist
No         Yes
 
47) Number of Neurologists
 
48) Neurologist with stroke expertise (or Stroke physician)?
Does your center have a neurologist with expertise in stroke? Or a stroke physician?
No         Yes
 
49) Stroke Specialists for Prevention and Rehabilitation
Access to physicians with stroke expertise in stroke prevention and stroke rehabilitation
No         Yes
 
50) Nursing assistants
No         Yes
 
51) Pharmacist
No         Yes
 
52) Social worker/case manager
No         Yes
 
53) Palliative Care team
No         Yes
 
54) Speech-Language Pathologist
No         Yes
 
55) Physiotherapist
No         Yes
 
56) Occupational Therapist
No         Yes
 
57) Neurosurgeon
No         Yes
 
58) Interventional Neurologist OR Endovascular Neurosurgeon OR Interventional Neuroradiologist in hospital
No         Yes
 
59) Interventional Neurologist OR Endovascular Neurosurgeon, OR Interventional Neuroradiologist available 24h/day, 7 days/week?
No         Yes
 
60) How many Interventional Neurologist OR Endovascular Neurosurgeon OR Interventional Neuroradiologist in hospital
 
STROKE UNIT PROTOCOLS
Is there access to stroke unit protocols to guide acute stroke care based on best practice guidelines?
 
61) Swallowing assessment
You can check "yes" If is described that swallowing has not been evaluated because the patient is intubated or in coma,
No         Yes
 
62) Nutrition, hydration, glucose
No         Yes
 
63) Mobility and prophylaxis
Functional status, mobility, DVT risk and prophylaxis protocols
No         Yes
 
64) Level of dependency
No         Yes
 
65) Skin Integrity
No         Yes
 
66) bladder and bowel continence
Evaluation of bladder and bowel continence
No         Yes
 
67) Temperature management
No         Yes
 
68) Positioning, mobilization
Protocols for patient positioning and mobilization
No         Yes
 
69) Prevention therapies
Access to stroke prevention therapies such as antiplatelet therapy, anticoagulants, statins, lifestyle change recommendations, blood pressure management
No         Yes
 
70) Stroke prevention therapies
Choose all that apply

antiplatelet therapy
anticoagulants
blood pressure medication
anti diabetic drugs
statins
 
ADVANCED INTERVENTIONS
Which of the following advanced interventions are available?
 
71) Mechanical thrombectomy available?
No         Yes
 
72) Endovascular thrombectomy available 24/7
Mechanical thrombectomy available 24 hours a day, 7 days a week
No         Yes
 
73) STROKE SPECIALISTS FOR THROMBECTOMY
check below the specialist responsible for thrombectomy in your hospital (check all available)

Interventional Neurologist
Endovascular neurosurgeon
Interventional neuroradiologist
Vascular surgeon
Interventional cardiologist
Other
 
74) Number of thrombectomies in 1 year (if applicable)
if not available, please answer 0 (zero)
 
75) Hemicraniectomy for ischemic stroke 24/7
No         Yes
 
76) Neurosurgery for hemorrhagic stroke 24/7
Neurosurgery for hemorrhagic stroke 24/7 (including clipping and intraventricular drain placement)
No         Yes
 
77) Products to reverse coagulopathy
No         Yes
 
78) Which medication to reverse anticoagulation
Vitamina K plasma fresco congelado crioprecipitado complejo de protrombina Idarucizumabi Andexanet

Vitamina K
Fresh frozen plasma
Cryoprecipitate
Prothrombin complex
Idarucizumabi
Andexanet
 
79) Botulinum Toxin available for spasticity
No         Yes
 
80) Acute Stroke Unit
Access to acute stroke unit (mandatory for advanced centers from the second year)
No         Yes
 
81) Intensive care unit on site
No         Yes
 
82) Angio Suite available
No         Yes
 
83) Operating room
No         Yes
 
REHABILITATION
 
84) Early Functional Assessment
Early functional assessments, goal setting and individualized rehab plans developed
No         Yes
 
85) Early Rehabilitation
Early access to rehabilitation therapies – including cross training of skills to nurses, nursing assistants and family members
No         Yes
 
STROKE CARE ORGANIZATION
 
86) Stroke Director
No         Yes
 
87) Nurse Coordinator
usually they are nurses- but can be other health professionals - empowered to oversee the quality of acute stroke services, organize training programs, help to design and implement protocols
No         Yes
 
88) Stroke Task Force
Stroke Task Force (meets monthly) discusses data, guides, performance improvement
No         Yes
 
89) Weekly meetings
Interdisciplinary meetings weekly to discuss patient progress against treatment goals; update management plans
No         Yes
 
90) Patient and family education
Are patient and family education, skills training, and involvement in care planning being applied?
No         Yes
 
91) Material for patients
Printed stroke patient educational materials
No         Yes
 
92) Discharge plan
Is a discharge planning always available?
No         Yes
 
93) Stroke training
Stroke training programs for all levels of healthcare providers
No         Yes
 
94) Quality assessment
Participation in quality assessment of services (registry): At least 4 months of data collection in the registry and performance measures must be included in the platform before the visit
No         Yes
 
95) Stroke pathways in the region
Stroke pathways that define movement of stroke patients across region to higher and lower levels of services as required
No         Yes
 
96) Coordinated referral system
Coordinated referral system for stroke patients
No         Yes
 
97) Telestroke
Provide telestroke consultations to smaller and more rural centers
No         Yes
 
98) Education of Population
No         Yes
 
99) Research in stroke
No         Yes
 
 
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