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What’s Behind the Pursuit for Excellence?

By Dr. Nelson Novarro

At the most recent Johns Hopkins Medicine International Partners Forum, I had the pleasure of presenting Pacífica Salud Hospital Punta Pacífica’s (HPP) journey to open a stroke center of excellence.

We successfully opened the center last June, but our journey certainly wasn’t an easy one.

We began to discuss the possibility of opening a stroke center at HPP as far back as 2007. Stroke and cardiovascular disease is a prevalent—and increasing—risk in our country. As many as 1,500 Panamanians die each year from cardiovascular diseases. A dedicated center to prevent and treat this deadly threat would be an important way to serve our patient population.

Our hearts and minds were in the right place, but we didn’t yet have the clinical and administrative experience to bring the center to fruition. Fortunately, we had a longstanding affiliation with Johns Hopkins Medicine International and had been receiving consulting in clinical and quality program development and patient safety since 2001.

Hopkins physicians have a deep pool of expertise in stroke. The Comprehensive Stroke Center at The Johns Hopkins Hospital, directed by fellow Panamanian Dr. Victor Urrutia, has earned Joint Commission International certification as a comprehensive stroke center for providing specialized care for patients with even the most challenging strokes throughout their diagnosis, treatment and recovery.

Together with our Johns Hopkins colleagues, we created a roadmap toward building a stroke center of excellence at HPP. We assessed our resources to perform advanced imaging techniques; the availability of our staff in the imaging, operating room and endovascular facilities; and the capacity of those staff members’ training in vascular neurology, neurosurgery and endovascular procedures.

We then trained 234 clinicians and other professionals, and we educated our community about the symptoms and risk of stroke. We also strengthened our performance on best-practice protocols for a variety of stroke types, as well as our ability to consistently provide urgent treatment to acute stroke patients.

We did a lot leading up to the center’s opening. We now have all the resources in place to allow us to take care of stroke patients with the newest and best technology and treatments.

But this is simply the start. We will continue to improve stroke care with education, reaching out to people to teach them about preventing and recognizing strokes, as well as improving our pre-hospital care. We also will begin to apply for the all-important certification from the Joint Commission International to ensure we are meeting the highest standards in the quality of our stroke care.

Like Johns Hopkins, Pacífica Salud Hospital Punta Pacifica’s mission is to provide the best care possible to our patients. I’m very grateful to share this value with Johns Hopkins and appreciate the willingness of our colleagues there to pass along their trade secrets for building a successful center of excellence.

Dr. Nelson Novarro is the coordinator of the stroke program at Pacífica Salud Hospital Punta Pacífica. Dr. Novarro specializes in neurology and internal Medicine, and he is a fellow of the American College of Physicians. He participated in the III European Master in Stroke Medicine (European Stroke Organization) and has a master’s degree in neuroscience and behavioral biology. He has been an instrumental champion in developing a stroke program in Panama.



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