What is Primary Stroke Service (PSS)?

In 2002 , the Massachusetts Department of Public Health (MDPH) initiated a program with the goal of improving stroke care in Massachusetts. The Department promulgated licensure regulations in March 2004 which specified the requirements for a hospital to become a designated Primary Stroke Services (PSS). Only hospitals that are licensed by the Department of Public Health can apply to become designated. MDPH began designating hospitals meeting the requirements for Primary Stroke Service (PSS) later in 2004. PSS designation requires that hospitals follow very specific stroke protocols for patient assessment and care and commit to continuous education of the public about warning signs and symptoms of stroke. As part of its PSS designation, a hospital must provide emergency diagnostic and therapeutic services 24 hours-a-day, seven days-a-week to patients presenting with symptoms of acute stroke. These services are needed to ensure that every patient who arrives within hours of the start of his/her stroke symptoms and is eligible can be treated with IV-tPA. In follow up to the PSS program, a diversion plan for ambulances was created requiring the transport of patients presenting with symptoms of acute stroke to the nearest designated PSS hospital (bypassing non-PSS hospitals even if they are closer).

Where does the Primary Stroke Service (PSS) data come from?

As part of their designation, the PSS hospitals are required to collect data on all patients who present to their Emergency Departments with acute stroke symptoms within three hours from when they were last known to be well. These data are entered without patient identifiers into a central registry. The statewide information in the graphs on the data page of this website represents data from the PSS registry for the time periods of January 2006 to December 2007 (aggregate data only) and January 2007 to December 2008. The national comparative statistics for the aggregate data are provided from the American Heart Association's Get With The GuidelinesSM-Stroke program which includes acute stroke and transient ischemic attack (TIA) cases from over 1,400 hospitals located in all 50 states, including districts and territories (DC & PR).