Statewide initiative launches to improve stroke care with $6.8M backing it

The American Stroke Association—a division of the American Heart Association—has announced a statewide initiative to improve stroke care across Hawaiʻi, supported by $6.8 million in funding. The effort, called Mission: Lifeline Stroke, is backed by a $5.8 million grant from The Leona M. and Harry B. Helmsley Charitable Trust and $1 million from the American Heart Association.

Stroke is the third-leading cause of death in Hawaiʻi and the leading cause of disability, according to the Association. Cardiovascular disease, which includes stroke and heart conditions, is the state’s number one cause of death.

The new initiative aims to connect all aspects of acute stroke care—from emergency responders to rehabilitation facilities—into a more integrated statewide system. By enhancing coordination between stakeholders, the initiative hopes stroke patients will receive timely and effective treatment, including rehabilitation and access to post-acute care facilities, no matter where they live.

The effort will involve 24 hospitals, including all seven certified stroke centers and nine critical access hospitals. Eighteen of these facilities will adopt post-acute stroke care quality standards to improve long-term outcomes.

“When it comes to stroke, every second counts,” said Gov. Josh Green, a physician. “This initiative is a transformative step in ensuring that even our most rural communities have access to lifesaving stroke care.”

The Hawaiʻi Stroke Coalition, the Hawaiʻi Department of Health and Emergency Medical Services will champion to guide a statewide stroke system of care, including: 

• Improved public awareness of the risk factors and symptoms of a stroke and the need to call 9-1-1, with focused attention on diverse ethnic populations disproportionately impacted by cardiovascular risk factors and disease  
• A coordinated EMS network, well-trained to identify and treat suspected stroke patients quickly and transport them to the most appropriate facility, and early activation of downstream care teams; 
• Well-trained hospital staff who are prepared to properly treat stroke patients and transfer, when appropriate, to higher levels of care and high-quality rehabilitation services; 
• Coordination and collaboration among hospitals across the islands; 
• Seamless discharge to high-quality, post-acute stroke rehabilitation and recovery care; 
• Guideline-directed, standardized care in post-acute stroke care facilities to improve recovery and quality of life and skilled nursing facilities certified in post-acute stroke care; 
• A sustainable statewide quality improvement data system to monitor patient care, identify successes and areas in need of further improvement and support; 
• Robust, collaborative infrastructure for long-term attention to stroke outcomes across the state; and a report to guide future stroke efforts for key stakeholders across the state. 

“We are proud to lead this initiative in collaboration with Hawaiʻi’s leaders, ensuring that patients—regardless of where they live—have access to timely, high-quality stroke care,” said Nancy Brown, CEO of the American Heart Association.

Mission: Lifeline Stroke Hawaiʻi will also implement a statewide quality improvement data system to track outcomes and guide future stroke care efforts. It notes that stroke mortality rates are predominantly higher among Native Hawaiians and Pacific Islanders.

The program is part of a broader national model. Since 2010, the Helmsley Trust has committed nearly $97 million to stroke and cardiac care initiatives with the American Heart Association. Their support has advanced Mission: Lifeline STEMI and Stroke projects in South Dakota, North Dakota, Nebraska, Wyoming, Montana, Minnesota and Iowa.

Walter Panzirer, a trustee for the Helmsley Charitable Trust, said the effort is especially critical for underserved areas. “We believe this program is the best way to significantly enhance stroke care, especially in underserved rural communities,” he said.