We are very pleased that your hospital is interested in applying for certification as an Acute Stroke Ready Hospital by the Stroke Society of the Philippines!

Acute Stroke Ready Hospitals (ASRH) is defined as, “hospitals which can provide timely, evidence-based care to most patients with an acute stroke”. The vision and intent of the ASRH is to provide initial diagnostic services, stabilization, emergent care, and therapies to patients with acute stroke who are seen at the Emergency Room. If there is no acute stroke units in the hospital, they would then arrange for appropriate patients to be transferred to another hospital that would provide ongoing, definitive care.

The Stroke Society of the Philippines with its Committee on Certifications and Committee on Education aims to elevate the quality of stroke care and management by Philippine Hospitals, yours included. Aside from making your hospital acute stroke ready, we also aim to heighten your knowledge and skills in managing your patients across all stroke types and stroke continuum of care. We will coordinate with your stroke coordinator to plan and implement trainings and workshops (on-site or online) mainly focused in providing you with Level I (for new applicants) and Level II and III Stroke education (for certified hospitals) within the validity of your certification until re-certification.

Roles of Acute Stroke Ready Hospitals

An ASRH will provide immediate and time-critical care to the stroke patient which includes initial emergency evaluation and screening, stroke scale assessment, and thrombolysis, if warranted. In order to administer optimum level of care to acute stroke patients, an ASRH utilizes standardized and evidence-based protocols, and has 24-hour access to neurological/stroke expertise, either internally or through telemedicine for consultation. Having an ASRH will reduce the time of treatment of patients with acute ischemic strokes who may benefit from intravenous thrombolysis using recombinant Tissue Plasminogen Activator (rTPA) though early identification, communication, and delivery of the stroke patient to other hospitals, if warranted. This will also reduce delays and improve the care of other stroke patients who may not qualify for thrombolysis such as those with hemorrhagic strokes, or patients with acute ischemic stroke beyond the time window for thrombolysis or those who had completely resolved symptoms suggestive of transient cerebral ischemic attacks.

Benefits of Being an SSP Certified Acute Stroke Ready Hospital

Aside from being recognized as an institution which can provide immediate and time-critical care to stroke patients, as an ASRH certified by the SSP, you will be given priority in the excellent, updated, and evidence-based trainings and workshops which will be provided the Education Committee. You will also receive guidance from the Certifications Committee in monitoring your progress as an ASRH, identify issues, and offer solutions, when necessary, with the end-point of working towards wholistic management across the stroke continuum of care. Once certified, your institution will be included in the list of ASRH in the SSP website and within the Stroke App which will provide end-users with a locator map and directions to the nearest ASRH.

We have provided you with the SSP-ASRH Certification Program Quick Reference Guide which contains information about the key elements, requirements, details about what documents need to be submitted, expectations during a site visit, and checklist of application requirements for your reference. You may download the reference guide here.

Basic Key Elements Required for Certification
• Key Element 1: Acute Stroke Team
• Key Element 2: Brain Imaging and Laboratory Testing Capability
• Key Element 3: Capacity to Provide Thrombolysis
• Key Element 4: Written Stroke Protocols
• Key Element 5: Stroke Education
• Key Element 6: Acute Stroke Team Log
• Key Element 7: Hospital Stroke Database/ Stroke Registry

SSP-ASRH Certification Categories

TIER 1: These are hospitals in which the stroke services are still starting or those with deficiencies in the submitted required documents. Complied with Key Elements 1 to 3 but not fully Key Elements 4 to 7. Certified for one (1) year.
TIER 2: These are hospitals with established stroke services and have submitted the complete requirements. Complied with Key Elements 1 to 7. Certified for three (3) years.
TIER 3: These are hospitals with established stroke services and have submitted the complete requirements. Complied with Key Elements 1 to 7. This is granted to institutions with accredited Fellowship Training in Stroke and Vascular Neurology. Stroke-related research output is mandatory. Certified for 5 years.

Process Flow for Certification as an Acute Stroke Ready Hospital

1. The Committee on Certifications will identify hospitals which potentially may be certified as an SSP-ASRH using the ASRH Certification Checklist provided in the Quick Reference Guide. You may refer to this checklist as your reference for the required Key Elements. For hospitals located in the provinces, the Regional Representatives will recommend these hospitals to the National Committee for consideration.
2. The Committee will write to the recommended hospitals to inform them about the SSP ASRH Certification Program and to invite them if they are interested to be certified.
3. Hospitals may also apply directly to the Certifications Committee by sending to us your letter of intent as detailed below.
4. If interested, the Chief Executive Officer (CEO) of your hospital may send a letter of intent for ASRH certification and an Attestation Letter declaring that the documentation provided is a true representation of the hospital’s processes, protocols, and capabilities. The letter shall be addressed to Dr. Maria Socorro F. Sarfati, President of the Stroke Society of the Philippines, thru Dr. Jose C. Navarro, Chair of the Committee on Certifications, Stroke Society of the Philippines. Both letter of intent and attestation letter must use the hospital letterhead, signed by the CEO, supporting the accuracy of the application and fulfillment of requirements.
5. Initial training/workshop (Level I Stroke Education) provided by the SSP Education Committee is a pre-requisite before evaluation of your application. If you have not undergone this step/level, please communicate with Dr. Geraldine Sienna L. Mariano, Head of SSP Education Committee, for scheduling. If you fulfill the required Key Elements but have not yet undergone the Level 1 workshop, you may still be considered for certification provided that you complete this requirement within 6 months from the time of being certified.
6. Submit all the required documents to our e-mail at [email protected] with courtesy copy to [email protected]. Please make sure that all files have short pertinent titles and are sent using just one message so that your application documents will be more organized. You may refer to the Acute Stroke Ready Hospital Certification Checklist for your reference.
7. You will receive an e-mail from us that your ASRH certification application was received and that the Committee on Certifications will be reviewing your application. Settle the certification fee (instructions will be provided in the e-mail). Once reviewed, an on-site visit will be scheduled, if deemed necessary.
8. An ASRH Certification Report will be formulated from both the document review and the on-site visit (if done) and will include identified areas of feedback and opportunities for improvement.
9. Once approved, the applying hospital will receive an e-mail from the Committee of the notification of certification status and a digital copy of the ASRH Certificate. The courier charge will be shouldered by the applicant hospital. If the application is not approved, you will be given at least one (1) year to satisfy the criteria through the guidance of the Committee.

If you have questions or clarifications, you may contact us at [email protected].

For SSP-ASRH, you may update your thrombolysis readiness using this link. This is important in maintaining your status in the Stroke Map and Stroke App.