PINEHURST – Because of its location in the American “Stroke Belt” and the aging populations of surrounding retirement communities, FirstHealth Moore Regional Hospital has moved toward an even more comprehensive stroke care program that includes the addition of two neurohospitalists to its Hospitalist Service staff.
Stroke is a leading cause of long-term disability and the fourth leading cause of death in the United States.
Neurohospitalists Sarah Uffindell, M.D., and Steven Lewis, M.D., recently joined Moore Regional's Hospitalist Service team. They provide 24/7 stroke care coverage for the hospital, which averages nearly 50 patients with a diagnosis of stroke, mini-stroke or cerebral hemorrhage each month.
“There are stroke patients here every day,” says Dr. Uffindell, “and we have a neurohospitalist available for the hospital at any given time.”
Neurohospitalists are hospital-based physicians who specialize in the care of patients with neurological conditions such as stroke and other diseases of the nervous system. Both Dr. Uffindell, who is stroke medical director, and Dr. Lewis have years of experience in neurological care. Both work under the medical direction of Gary Gammon, M.D., medical director of the Hospitalist Service.
Before coming to Moore Regional, Dr. Uffindell had 10 years of practice in general neurology, including eight years as a neurohospitalist, at Loma Linda University Medical Center in California. She earned her medical degree from the Loma Linda University School of Medicine and completed her internship and neurology residency at Loma Linda University Medical Center.
She is board certified in neurology.
Dr. Lewis earned his medical degree from the West Virginia University School of Medicine in Morgantown and completed his internship and neurology residency at the Walter Reed Army Medical Center in Washington, D.C. Before joining the Moore Regional medical staff, he was chief/clinical director, Department of Brain Injury Medicine at Womack Army Medical Center and site director of the Defense and Veterans Brain Injury Center at Fort Bragg.
He is also board certified in neurology.
According to Debbie DeLong, administrative director of Hospitalist Services, Moore Regional's around-the-clock neurohospitalist service provides specialty evaluation and treatment of a variety of neurological conditions including altered mental status, seizure disorders, nervous system infections and multiple sclerosis as well as stroke.
Neurohospitalists are especially helpful with the treatment of stroke patients requiring the medication tPA, the so-called “clot-busting drug,” which can improve a patient's chance of stroke recovery or lessen the chance of disability if administered within a specific time frame.
“The availability of a hospital-based neurologist is an advantage for both the hospital and local neurologists given the time-sensitive nature of tPA,” says Dr. Lewis. “It also contributes to the efficiency of the private practice by allowing neurologists to remain in their office instead of having to leave the practice to attend to patients in the emergency department.”
Before the neurohospitalist program, local private practice neurologists were responsible for patient care both inside the hospital and outside in their clinics. Now both groups can concentrate on their practice in one location rather than running back and forth.
The neurohospitalists work with the outpatient neurologist group in arranging long-term follow-up for the neurology patients.
“FirstHealth's decision to develop this service was based on the need of the local neurology practices to be able to focus exclusively on their outpatient practice,” says Dr. Gammon, “ensuring the responsible use of resources and implementing evidence-based practice in the hospital.”
The neurohospitalist program also furthers Moore Regional in its goal of becoming a Primary Stroke Center, a Joint Commission accreditation that assures the public that the designated hospital follows evidence-based best practices in its stroke care from admission to discharge.
As “stroke coordinator,” Dawn Enterline, R.N., of FirstHealth Clinical Practice, assists Dr. Uffindell with updates to stroke care policies and procedures and helps identify potential changes to work flow that ensure patient care efficiency and communication. She is also responsible for stroke education, a significant focus in any stroke care program, according to Dr. Uffindell.
“In addition to medications for high blood pressure, high cholesterol and heart rhythm problems, we want to teach people that they can do things to reduce their risk of strokes by managing their weight, getting exercise, eating a healthy diet and stopping smoking,” Dr. Uffindell says. “Our goal is not just to treat stroke, but to help prevent it from happening.”