The Chulalongkorn Stroke Center of Excellence, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society was established in 2006. The center aim to develop medical services in ischemic stroke patients as well as disease prevention and long-term medical care by the multidisciplinary team.

The Chulalongkorn Stroke Center of Excellence initiated the intravenous thrombolytic therapy in patients with acute ischemic stroke for the first time in Thailand in 1996. The emergency stroke care system (Stroke fast track) in King Chulalongkorn Memorial Hospital has developed since 1998. Our center is the comprehensive stroke center which provides the comprehensive stroke care in acute phase including advanced neuroimaging, medical treatment, and endovascular intervention and post stroke care including rehabilitation, the stroke follow up clinic, and home visit.

Chulalongkorn Stroke Center of Excellence is also the referrals center offering both thrombolytic and mechanical thrombectomy and providing telestroke consultation to support other hospitals in Thailand and neighboring countries such as the Mittaphap Hospital, Vientiane, Laos.

Stroke unit and stroke ICU provide medical care to ischemic stroke patients. Both units are managed by multidisciplinary experts with well-equipped devices including stroke robots that can provide an effective communication system among vascular neurologists and physicians or medical personals who are working in the ward at any time.

The long term post stroke follow-up is also provided for effective physical and mental rehabilitation in patients. The stroke clinic is where patients can get post-treatment follow-up from a multidisciplinary team. The self-help group is led by stroke nurses and created for exchanging stroke care experience among patients and caregiver. “Home Health Care” is a home visit program for stroke patient to provide secondary stroke prevention and medical advice by the nursing staffs. Our center incorporate technology for long term post stroke care including the “CU stroke” application is initiated for recording health parameters for follow-up visit and “stroke home robot” to support the patients’ self-assessment at home.

“World Stroke Day” is held annually in October by the Chulalongkorn Stroke Center of Excellence to raise public awareness regarding stroke and stroke prevention. The event is joined by the Chula Neuroscience Center to provide stroke screening tests for the participants.

Achievements / Key Milestones

1. World Stroke Organization Angels Award 2019 (Platinum status) from the World Stroke Organization.
   
   
2. Thailand Angels Award (Diamond status) 2018
   
   
3. The Best Practice of Non-communicable diseases 2007 from the Ministry of Public Health from the project “The potential development of a network of hospitals for the treatment of patients who have suffered an acute ischemic stroke via the Telestroke system” at King Chulalongkorn Memorial Hospital.
   
   
4. Thailand Public Service Awards 2016 “Excellence Award on Quality Improvement Service” from the Public Sector Development Commission on Telestroke system for acute stroke treatment.
   
   
5. The Outstanding People’s Service Quality Award 2010, from the Public Sector Development Commission for the complete workflow of stroke medical care procedures.
   
   
6. The BUPA Clinical Excellence Award 2005 from Bupa Insurance for stroke patient care

The Chulalongkorn Stroke Center of Excellence is well recognized and welcomes medical personnel from within the country and internationally for academic sharing of information. The Center itself is certified as the Certified Primary Stroke Center (CPSC) from Healthcare Accreditation Institute (Public Organization) and Thai Stroke Society and is certified the Standard Stroke Center Certification from the Department of Medical Services, Ministry of Public Health.

There is so much pride for Chulalongkorn Stroke Center of Excellence in its use of advanced technology for medical care in association with other departments such as an acute stroke robot for medical consultation in King Chulalongkorn Memorial Hospital. The expert personnel both in-office hours or out of office hours are regularly available for medical advice. King Chulalongkorn Memorial Hospital is the first government hospital where strokerobots are used for medical treatment.

Currently, the stroke robot is at the ICU stroke and the stroke unit. The CU Stroke application was successfully developed for self-assessment and risk assessment for stroke disease via a smartphone or a tablet device.  The medical service has also expanded to neighboring countries: Mittaphab hospital, Vientiane, Lao PDR where the first patient with acute ischemic stroke received intravenous thrombolysis in 2016, resulting in King Chulalongkorn Memorial Hospital gaining the reputation as the leading Stroke Center of Excellence nationally and internationally.

Obligation

1. Provide medical care for acute and chronic ischemic stroke patients in terms of stroke prevention and treatment, rehabilitation, complications prevention by multidisciplinary teams. To become a prototype center of comprehensive stroke therapy at the national and international levels.
2. Provide tertiary advanced medical services for stroke diagnosis and therapy.
3. To become a stroke training center for physicians and medical personnel to produce qualified and quality personnel at the national and international levels.
4. To become a recognized institution for stroke study, research and innovations as well as a national and international reference source in stroke therapy. 

Vision

We aim to be the leading stroke prevention and treatment center at an international level.

Mission

1. To provide medical services to ischemic stroke patients, both acute and chronic care.
2. To provide tertiary advanced medical services for strokes.
3. To be the training center producing quality medical personnel for stroke expertise at a national and international levels.
4. To be the academic and stroke research and development center at national and international levels.

Support Activities

The Center provides efficient and standard medical care for stoke patients by multidisciplinary teams at all stages of the disease.

1. Pre-hospital stage
   • Patient care at this stage is provided by King Chulalongkorn Memorial Hospital’s efficient EMS system in collaboration with personnel of its Emergency Unit and Chulalongkorn Stroke Center of Excellence. Admit patients with suspected stroke symptoms in its assigned areas 24 hours a day, seven days a week and coordinate with the National Institute for Emergency Medicine. The multidisciplinary teams can provide efficient preliminary diagnostic, patient care and referral services for stroke patients.
2. Stroke Fast Track System
   • Provide Emergency Room patient care by multidisciplinary teams.
   • Use 24-hour CT Scan and MRI services for effective stroke diagnosis by radiologists who specialize in the interpretation of brain MRI. CT Scan results can be interpreted within 20 minutes of examination completion while MRI, MRA, CTA results can be interpreted within 2 hours. Telemedicine is also used to confirm the reading and interpretation of these results.
   • In case of an acute ischemic stroke diagnosis, intravenous thrombolytic therapy and clot retrieval procedures are available 24 hours a day, seven days a week.
   • In case if a hemorrhagic stroke diagnosis, patients will be treated by neurological surgeons who can promptly diagnose and treat them in an operating room well-equipped with equipment and personnel who can perform a brain surgery 24 hours a day, seven days a week.
3. Provide patient care in a standard and special stroke wards where a surgical team can be promptly assembled.
   • In case of an acute ischemic stroke diagnosis, a 6-bed ICU Stroke Ward and a 15-bed Stroke Unit are available on Floor 18 A of Bhumisiri Mangkhalanusorn Building for prompt medical care by multidisciplinary teams
   • Carotid Ultrasound and Transcranial Doppler Ultrasound is used for cerebral blood vessels check. CT, CTA, CTP, MRI, MRA, MRP, Cerebral angiogram scans are available as well as additional diagnostic tests such as Transthoracic echocardiography, Transesophageal echocardiography, Holter.
   • In case of a  hemorrhagic stroke diagnosis, two ICU Neurosurgery wards are available at SorKor 8 Building and Floor 7B of Bhumisiri Mangkhalanusorn Building and the Neurosurgery Ward on Floor 16 A of Bhumisiri Mangkhalanusorn Building under the supervision of multidisciplinary teams in neurosurgery.
4. Patient referral system. King Chulalongkorn Memorial Hospital is the No. 1 host of the Stroke Service Plan for Bangkok’s 13^th Health Zone. It is also the host for 23 hospitals in Network I and the host for other hospitals across Thailand for stoke treatment and consultation. It coordinates with other Patient Referral Centers and uses telemedicine for swift referral coordination 24 hours a day, seven days a week. More than 120 patients per year are treated under this system. 
5. Rehabilitative care
   • Provide rehabilitative care services such as physical therapy, occupational therapy, and speech therapy to all stroke patients who need them, starting from the initial phase of illness to the post-discharge period during which the patients are treated as outpatients by the Rehabilitative Medicine Clinic, the Telestroke Rehabilitation system and the Telehealth system of King Chulalongkorn Memorial Hospital. The Continuous Patient Care Center provides home care visit and Telenursing services for patients who are discharged from the hospital.
   • Continuous outpatient multidisciplinary follow-up services for stroke patients at three months and one year intervals is provided to post-discharge stroke patients by the Stroke Clinic and Tele Stroke Clinic. After one year, patient care continues under the Telephone Stroke Follow Up system and the Neurology Clinic.  
   • Two social workers are available to provide consultation or social work assistance for both patients and their relatives. Also available are nutritionists to provide nutritional advice, pharmacists to provide pharmaceutical services, and psychiatrists to provide mental health care services.

• Instruction. The Center offers several residency training programs for physicians in internal medicine, neurology, surgery, neurological surgery, and vascular neurology in accordance with the guidelines of the Medical Council of Thailand and the relevant Royal Colleges in each specialty. It also offers a multidisciplinary approach to the instruction of undergraduate and graduate medical students. Stroke training programs for nursing personnel and other medical personnel are offered on a continuous basis.
• Research. It is the stroke research center that conducts research and joint research, supports and coordinates inter-disciplinary and inter-institutional research with other national and international agencies.
• Academic services. Disseminate advanced knowledge and technologies in stroke therapy and prevention to related personnel and the general population. Provide pro-active services through collaboration with the Red Cross Stations and community organizations to disseminate knowledge on risk prevention and recognition of initial stroke symptoms to enable patients to access hospital services as fast as possible in order to reduce the stroke-related mortality and disability rates.

Services

The Chulalongkorn Stroke Center of Excellence provides a multidisciplinary service to stroke patients including disease prevention, medical care, long-term treatment, home health care, out-patient stroke clinics by multidisciplinary teams such as neurologist, internist, neurosurgeon, psychiatrists, specialist nurses, nutritionists, social workers and Red Cross volunteers. The services are aimed to provide patients with comprehensive physical and mental rehabilitation.

The Chulalongkorn Stroke Center of Excellence is also a training center for neurology residents and vascular neurology fellows which provides both academic activities suitable for developing essential skills in stroke care and research environment for clinical and advanced stroke research which are published in medical journals both nationally and internationally.