Introduction: Eastern North Carolina is often considered to be within the “buckle” of the stroke belt. This region of the southeastern United States has a high stroke incidence of and rate of mortality. Vidant Health is a regional health system composed of 8 hospitals serving 29 counties in eastern North Carolina. In 2016, 6 Vidant hospitals partnered with the Wake Forest Baptist Telestroke Network to provide 24/7 access to board certified vascular neurologists and improve access to tPA and neuroendovascular procedures. The Wake Forest Baptist Telestroke Network was established in 2009 to reduce death and disability caused by strokes in North Carolina. While the network serves 20 hospitals across North Carolina, the Vidant partnership is unique in that it houses a regional network within the larger state-wide network.
Method: Three Vidant hospitals (Beaufort, Edgecombe and Duplin) were added to the network in February, 2016, with the additional three (Bertie, Chowan, and Roanoke-Chowan) joining in May, 2016. Health system wide stroke code policies were established including an endovascular protocol implemented for rapid transfer of appropriate patients to the regional hub, Vidant Medical Center, for interventional therapies.
Results: With implementation of the endovascular protocol, interventional cases at Vidant Medical Center have increased from 5 in 2015 to 19 in 2016 (as of August). Year to date tPA administration has already surpassed that of 2015 and 2014 at one site (Beaufort, 7 in 2016 vs 6 in 2015 and 3 in 2014), and is on track to surpass previous years’ rates at other network sites. Total stroke transfers year to date at 2 sites have surpassed that of 2015 at 2 sites (Beaufort, 7 in 2016 vs 5 in 2015, and Roanoke-Chowan, 4 in 2016 vs 0 in 2015) and total network transfers to date are over 50% of year- end transfers in 2015 and 2014.
Conclusions: The partnership between The Wake Forest Baptist Telestroke Network and Vidant Health has created a regional stroke network within a larger state-wide model, increasing availability and utilization of tPA and endovascular therapies in Eastern North Carolina.