Title
Fire Department Contract with Dignity Health for Mobile Stroke Unit Pilot Program (Ordinance S-43491)
Description
Request authorization for the City Manager, or his designee, to enter into a contract with Dignity Health (Dignity), on behalf of Dignity's St. Joseph's Hospital and Medical Center and its Barrow Neurological Institute, for establishment and implementation of a Mobile Stroke Unit (MSU) Pilot Program. Authorization also is requested for the City Treasurer to accept funds from Dignity for associated Phoenix Fire Department (PFD) dispatch and communication services (dispatch through 911).
Report
Summary
The objective of the MSU Pilot Program is pre-hospital, "ASAP" diagnosis and possible administration of the "clot-busting" drug tPa (tissue plasminogen activator) to stroke patients in the field prior to, or during, hospital transport. The objective is to treat stroke patients to potentially improve neurological recovery and outcomes.
Stroke is the fifth leading cause of death in the U.S. and the leading cause of adult disability. According to Barrow, more than 800,000 strokes occur annually in the United States. With approximately 8,000 patients in Maricopa County, 5,500 are within the MSU response map (20 minutes), and approximately 2,500 are estimated to be tPa-eligible stroke patients who could benefit from this revolutionary, life-saving treatment. Further, the probability of a "good outcome" is reduced by 10 percent every 30 minutes that treatment is not provided. The safe time frame to treat stroke patients with the "clot-buster" drug tPa is limited to less than 4.5 hours from the onset of symptoms. Currently, approximately five percent of stroke patients receive tPa at all, and less than one percent within one hour.
The MSU Pilot Program will logistically provide that calls for assistance would be received by Fire 911, and both PFD and the MSU would be dispatched according to the 20-minute response map within Phoenix. If the assessed patient is eligible, MSU would administer the tPa IV and the patient would be transported to the closest appropriate stroke patient treatment facility as determined by the treating physician in collaboration with PFD paramedic personnel.
Contract Term
This request is for an agreement with Dignity Health, on behalf of Dignity's St. Joseph's Hospital and Medical Center and its Barrow Neurological Institute. The initial three-year term would be from approximately June 1, 2017 through May 31, 2020, and two one-year options through May 31, 2022. This contract will be non-exclusive. It is intended that other medical entities will have the opportunity to contract with PFD in the future, in an effort to expand the Mobile Stroke Program to ensure more comprehensive citywide coverage.
Financial Impact
The City will be reimbursed by Dignity for all associated dispatch and communication services (911). Dignity will provide its own vehicle, staffing, and all other necessary equipment.
Location
Twenty-minute response map within Phoenix based on Dignity's location.
Department
Responsible Department
This item is submitted by Assistant City Manager Milton Dohoney, Jr. and the Fire Department.