A DNV GL Healthcare survey for a stroke program begins with a data review that includes looking at trend lines, action plans for improving on some trends, goals and stretch goals, and how data are validated.

Next, a visit to the emergency department (ED) to understand the patient’s experience in entering the hospital for treatment, the agency describes in material provided to Hospital Peer Review. The surveyor will study the patient’s first moments in the ED, the personnel involved, the responsibilities of various team members, the documentation process, order sets, and how orders are processed when electronic tools are down. Surveyors always are interested in speaking with any team members interacting from other departments, such as pharmacists.

After the ED, the surveyor will move on to assessing CT scans, MRIs, and interventional radiology. The surveyor will pay close attention to how those departments and technicians are alerted, the care process, staffing, and educational requirements.

Following a lunch break, the surveyor will continue with a document review of “the binders” that include order sets, community education, transfer agreements, policies and procedures, medication management, informed consent, scope of service, call schedules, and emergency medical services contracts and education.

The surveyor often will end his or her day by touring the neurology intensive care unit as well as the subacute unit. Agents will engage with staff and ask them questions about stroke care, educational requirements, and their feedback on the stroke program.