Fill the Self-Assessment Form to evaluate your hospital.
You can see your classification according to the roadmap, the proportion of elements available according to all resources suggested, the items you need to complete all elements suggested. If you don’t reach the minimal criteria for classification, you can see the items you need to improve to reach the classification or to reach a superior level.
To apply for certification
- Fill out the Application.
- All mandatory items are considered minimal requirements to apply for classification to each category
- Beyond the mandatory requirements, hospitals will need to reach at least 75% of recommended elements to get the MENA Stroke Center Certification. In the second certification the centers will need to reach 85% of the recommended elements. Also, for recertification, the center must show improvement.
- The Center must demonstrate 4 months of data collection in the registry and performance meassures
The Electronic interactive resource
will show the % of resources available in the hospital according to all suggested in the WSO Roadmap category prior to the visit to evaluate potential candidates. If the system confirms the criteria, the hospital will be pre-certified and the center will receive a request for more documents for certification (in preparation for the onsite visit). These documents should be uploaded in the platform:
• Structure of hospital and stroke center (physical structure and staff; include support documents (certification of trainings or attendance list in trainings).
• Protocols used (reference or description)
• Patients pathway
• Educational program: frequency, professionals trained (in the hospital, pre-hospital, other hospitals, primary attention), population trained
• Performance measures – indicators measured, type of registry (local? National? International?) – if international, what registry? – frequency of evaluation, plans for improvement
• Organization of the network (pre-hospital? Other hospitals?)
An on-site hospital evaluation will then follow.
The visit will be scheduled from 2 to 6 months after the application (to allow time for the hospital to be prepared to the visit). The hospital will be in contact with the certification team during the preparation. The 2 certifiers (a doctor and a nurse selected by the country delegates) will visit the hospital:
• Stroke program overview
• Review of at least 10 patients included in the registry, by tracing their care from arrival to the hospital to discharge and evaluating the application of hospital protocols and evidence based practices and principles
• Review of policies and protocols
• Review of staff and credentialing
• Review of quality improvement projects and performance indicators
• Visit to the Emergency Room (ER), Intensive Care Unit, Stroke Wards/Unit, angiosuite (in Advanced centers) and meeting with the coordinator of stroke center and representatives of the stroke team, and other professionals from the hospital and ER
After the hospital visit, a Board Review will be scheduled.
The Board Review wlll be composed of: the 2 evaluators of each center (that will present the results of the center visited), 1 member of the working group, 1 or 2 members of the Executive committee from MENA region and 1 member of the Executive committee outside MENA-region. Each board meeting will discuss 4 to 5 centers. This board will approve the final certification of the center. The board will point potential deficiencies/areas of improvement and centers will be asked for actions plans to improve the service.
1 year after on site certification, the hospital will be evaluated for re-certification.
From the second year on, to maintain the certification, yearly the quality indicators will be reviewed (online) and the hospital will be visited for re-certification each 2 years.