The Neuro has had a stroke program, set up by Jeanne Teitelbaum and Rosa Sourial, since 1991, but it was only after the government restructuring of cerebrovascular care that the present tertiary care unit could be realized.
In 2015, the Quebec government designated The Neuro as a tertiary stroke centre. Designated centres treat victims of hyper-acute stroke, that is, a stroke that has occurred within 10-12 hours before the patient’s arrival at the centre. Such care requires a team to be extremely efficient and well organized, ready to perform complex procedures with very little notice. Every minute counts when treating such conditions, so the faster the team can intervene, the better the patient’s outcome.
The neurovascular team sees patients with everything from ischemic stroke, to intracerebral or ventricular hemorrhage, to sub-arachnoid hemorrhage. They are a multidisciplinary team composed of nurses, neurologists, neurosurgeons, internists, intensivists, physiotherapists, social workers, pharmacists and many other professions, who follow a patient, before, during, and after the intervention, to give them the best possible chance at a full recovery.
The entire team is part of the process of evaluating patient care. Every morning, professionals from each area come together for “the huddle”, where they discuss each patient’s condition, what tests have been completed, and what have yet to be done. Each member provides his or her own expertise, and this collaborative process improves patient care, according to Dr. Jeanne Teitelbaum, a neurologist and Co-Director of The Neuro’s Acute Stroke Service.
“This idea came from Rosa Sourial, the team’s nurse clinician, and the heart and soul of the team and the stroke program,” says Dr. Teitelbaum. “We could not have imagined how much this collaboration optimizes interventions. I think that I do a very good neurological examination, but I’ve learned that without the input from my physiotherapists, speech therapists and occupational therapists, my evaluations are incomplete. The social workers provide essential help returning patients home, and preparing me to speak to families. I learn as much as I teach working with this team, and that makes the care 100 times better.”
Dr. Teitelbaum also gives credit to the nurses, who came from diverse backgrounds when the unit was formed in 2014. Many came from outside the neurological field, and some were just starting their nursing careers, but they all integrated well to become a cohesive team that demonstrates strong work ethic and concern for the patient. She says many do extra tasks to make the patients comfortable, like cut their hair and sing with them, when there is nothing more urgent to be done.
Volunteers are also key to keeping the patient’s spirits up, according to Dr. Teitelbaum. Stroke patients are often depressed about their condition and the potential long-term disabilities it may cause. Volunteers who come in to sing and play music instruments life the patients’ spirits and Dr. Teitelbaum says that helps decrease their recovery time.
“I think that this team deserves recognition for its excellence, especially the contribution of Rosa Sourial, without whom the team would probably not exist, and certainly would not be as exceptional,” says Dr. Teitelbaum. “She often tells me, ‘everyone wants to do a good job. We just have to give them the tools, the support, the respect and the encouragement necessary.’”
The Interprofessional Team Prize of Profession Santé is awarded to a team that, because of its cohesion, allows the development and implementation of care and services for the benefit of patients. Congratulations to the neurovascular team for this excellent recognition.