Goldshire Hospital

Memorandum
November 3, 2016
To: Dr. Robert Goldshire
From: Kimberly Curtis, Project Manager
Carmen Acosta, Materials Coordinator
Shawn Massingill, Research Analyst
Timothy Miner, Research Analyst
Subject: Proposal for the Mobile Stroke Unit

Purpose
The purpose of our Proposal is to procure a Mobile Stroke Unit (MSU) for
Goldshire Hospitals Emergency Service Department. It is our belief that the
purchase of the unit will save valuable time and increase good outcomes for
victims of acute stroke and decrease costs of lengthy admissions.
Primary research has revealed positive outcomes including shorter lengths of
stay for stroke victims and faster initiation, where indicated, of the clot-bustion
medication Tissue Plasminogen Activator (tPA). It is widely accepted that early
intervention with tPA is of utmost importance during Ischemic Stroke (Collette).
Currently, the average call-to-treatment time is 1.5 hours, with 3 hours being the
accepted upper limit of treatment initiation (Collette). This unit has proven to
decrease valuable time between initial symptoms and treatment by providing
diagnostic tools at the emergency site versus in the Emergency Department (ED)
(Fassbender).

123 LITTLE ST., F

ORT, WORTH,

TX 76028
T 817-555-5555 U GOLDSHIREHOSPITAL.ORG

We would like to request authorization to conduct a feasibility study to include a

cost analysis, benefits and potential risks involved with acquiring and utilizing
an MSU.

Introduction
Ischemic Stroke is among the leading cause of death and disability in the U.S.
(Neale). Ischemic Strokes (those caused by a blood clot occluding vessels
feeding the brain) are different from Hemorrhagic Strokes (actual leaking of
blood into the brain space). Medications used for Ischemic Stroke can prove
fatal for patients suffering Hemorrhagic Strokes.
Currently, the standard diagnostic tools, Coputed Tomography (CT) imaging
and laboratory tests, must be performed in the ED setting. Transport times from
some rural areas can be as much as 25 minutes and as short as 10 minutes
(Fassbender). As our Hospital has only one CT scanner, there is potential for
delay when the machine is already in use.
A Mobile Stroke Unit is a specialized transport vehicle, similar to a regular
ambulance but outfitted for the special needs of stroke victims (Fassbender). It
contains a CT scanner, a small laboratory and some even contain tPA ready for
administration. Personnel typically consist of one CT Technician, a Nurse, and
a Paramedic. Once a 911 call has been made, and it is determined that someone
may be having a stroke, the unit can be dispatched. Imaging and laboratory
findings completed in the field can be relayed to a Neuro-Diagnostician at the
Hospital through secured wireless internet connection. This allows for the
distinction to be made between a patient who would benefit from thrombolytic
medications and one who would not.

Proposed Tasks
With the approval of the Board of Directors and Dr. Robert Goldshire we would
like to perform the four tasks listed below to assist us in evaluating the benefit of
acquiring a MSU for our Hospital.
Task 1. Produce an initial cost analysis of a MSU
We will determine the overall cost of a new unit and the annual operating costs
associated with maintenance of the vehicle and its specialized equipment.
Task 2. Determine the average length of Hospital stay, including
rehabilitation time, and the costs associated with Stroke patients.
We will research the fiscal reports from Goldshire and compare them with other
hospitals in the United States. We will compare the costs of shorter stays due to
earlier treatment and longer stays due to later treatment.
Task 3. Acquire an understanding of how the unit works and the personnel
typically required for its use
We would begin our research by reading articles in medical publications and
from the manufacturers own website. We hope to gain a functional
understanding of the inner and outer mechanical processes.
Task 4. Identify positive and negative trends and outcomes associated with
MSUs
To provide a balanced perspective, and because most medical devices will have
some level of risk associated with their use, we will seek for reports of mishaps
or problems with MSU use. We will include any positive findings as well.
Task 5. Analysis of data and present findings and recommendations
We would prepare a formal document for dissemination to the Board of
Directors and upload the same to a Wiki to allow for current employees to
3

review and advise. Revisions would be considered and included where

appropriate and the final document to be presented to the CEO, the Hospital
Sponsoring Physicians, and interested parties.

Schedule
Task
Task 1:
Produce an
initial cost
analysis of a
MSU
Task 2:
Average
length of
Hospital stay
Task 3:How
the unit works
and the
personnel
Task 4: Out
comes
associated
with MSU
care
Task 5:
Prepare
Report

Date of Tasks

November

11

15

17

Experience
The Goldshire Research Team is a group of professionals with interest in the
medical field and a passion to save lives.
Carmen Acosta, currently pursuing a degree in Nursing. Has some
knowledge in this field having worked for 8 years for an Internal
Medicine doctor that specialized in geriatrics. Her interest stems from
the passion to assist others with the most advanced care for the best
chance of recovery.
Kimberly Curtis, currently pursuing a degree in Emergency
Management. Very enthusiastic about managing emergencies and
helping victims from all levels of medical problems and worldly
disasters. Has done some research on the effect of strokes and the
lifesaving treatments available.
Shawn Massingill, has been a Licensed Vocational Nurse for 16 years.
She has worked in Emergency Services for 5 years. She has treated
multiple stroke victims and seen the impact of the patients that arent
treated in a timely manner. Her passion comes from seeing the
devastating effects of victims without timely treatment.
Timothy Miner, currently pursuing a degree in Nursing. His plan is to
start as an EMT, a Paramedic, then a Nurse. His passions are derived
from his desire to help people in their time of need and to save lives. He
also wants the patient to receive the best and most advanced care
possible.

Work Cited
Collette, Rhiannon. "Mobile Stroke Unit Project Receives $6.8 Million from
PCORI to Expand Research in Houston and Beyond." The Business
Journals. N.p., 1 Sept. 2016. Web. 21 Nov. 2016.
Fassbender, K. "Mobile Stroke Unit." N.p., 2011. Web. 21 Nov. 2016.
Neale, Todd. "Taking Stroke TX on the Road." N.p., 21 Feb. 2014. Web. 29
Nov. 2016.