ABSTRACT
Background & Significance: The Covid-19 pandemic has created a host of challenges for healthcare systems and hospital teams that have put unprecedented stress on staff and leaders to re-design care and management of not only the Covid positive patient but also the hospitalized non- Covid patient. As this large healthcare system began to prepare for a Covid surge of patients, stroke program leaders recognized the need for alternative placement and management plans. With the redesignation of units and beds and deployment of staff into non-primary units, program leaders were concerned with not only placement of stroke patients outside of regular stroke and Neurocritical Care Units but also with non-trained stroke nursing staff caring for the patient. In response, this stroke program convened a working group to create alternative guidelines for care of the stroke patient during Covid surge and critical bed shortages. Design & Methods: The need for established criteria to guide all sites in the care of patients post IV thrombolytic or mechanical thrombectomy was the key objective. The alternative guideline was drafted and submitted to the system Covid clinical command center for emergent approval. Once approval given, education was provided to all stroke coordinators and key leaders at each site. To provide full access, guidelines were posted and available on the system SharePoint site for access to all team members. Results: The drafting of alternative stroke guidelines allowed for improved patient safety during our 27-hospital healthcare systems Covid surge. Care of multiple patients occurred outside normal critical care and stroke units with a decreased number of assessments for patients from the standard, pre-Covid and without increase safety events or adverse outcomes. The success of the alternative guidelines and this Covid effect on stroke care management not only helped our staff and patients during a time of need in safe care but also provided a new model of care for our stroke program leaders to consider and implement across our organizations.