In its first two weeks of operation, the new neuroscience center at Sharp Grossmont Hospital has averaged an 80% occupancy rate. That number is not terribly surprising, given that the La Mesa medical facility treated the 10th-most acute strokes in the state and handled the largest volume in San Diego County in 2023, according to state data.
Retired New York firefighter Thomas Daniels, 88, was among the first to occupy one of the 50 beds at what is officially called the Sharp Grossmont Hospital for Neuroscience. itted to Grossmont’s emergency department after having a stroke on April 29, he was transferred to the new center one day after it opened on May 1.
Thirteen days later, he was still there, feeling significant pain in his face, but able to chuckle over the enthusiastic welcome that occurred when the center’s first patients arrived.
“They were cheering for me and I said, ‘vote for me’ like I was running for governor,” he said. “That’s my way, just having fun.”
His ability to recall those memories made such a short amount of time after suffering a major neurological emergency is the entire point of building this new hospital within a hospital in the first place.
By dedicating space for neurological maladies, and filling that space with nurses, technicians and physicians all specificallytrained to handle brain-related care, the idea is to make it more likely that patients will receive medical interventions they need as quickly as possible.
Especially with stroke, the phrase “time is brain” has been the mantra in neurological care since the 1990s.
The speed and precision with which clot-busting drugs can be istered and surgery performed is literally the difference between full recovery and living the rest of one’s life with severely impaired movement. Or not surviving at all.
California hospitals are graded on their overall stroke mortality rates, a calculation of how many patients diagnosed with strokes die during treatment that is adjusted to for overall underlying health conditions and other factors. In 2023, the most recent year for which data are available, Grossmont’s state-issued stroke rating was “as expected,” though results have been mixed, with some “below expected” ratings in previous years.
The goal of all hospitals is to consistently achieve a “better” rating, indicating that their risk-adjusted mortality rates are lower than would be expected when compared to similarly sized peers.
While not explicitly referencing state ratings, Dr. Gregory Apel, an emergency medicine specialist and Grossmont’s chief medical officer, said that breaking off neurological care into its own hospital on the larger medical campus, one with its own entrance and its own specially trained staff, will allow care to reach new heights.
Having dedicated space, he said, allows the recruitment of physicians who specialize more deeply. Already, for example, Grossmont has recruited several endovascular neurosurgeons who are able to conduct both minimally invasive brain surgeries and larger “open” procedures that often require larger openings in the skull for access.
“We have specialists here that are coming from the highest institutions and fellowship programs to really provide that level of care that doesn’t exist outside of a neuroscience center,” Apel said.
The physical structure of the new hospital also enables deeper subspecialization. Several rooms in their own set-aside section of the larger facility are designated as an Epilepsy Monitoring Unit and are equipped with special seizure-monitoring equipment. This new feature justifies bringing in a whole new category of subspecialists.
“There is actually a fellowship program for epileptologists who are neurologists who do nothing but seizure-related care,” Apel said. “We are in the process of recruiting to get specifically that specialty for that unit to be able to deal with the most complex seizures.”
It includes its own 16-bed neurological intensive care unit, as well as another 16-bed “progressive” care unit for those whose conditions are not severe enough to need intensive care. And there are 18 additional beds dedicated to rehabilitation, a major function of any neurology program. Those with strokes and other conditions often must spend many hours with physical therapists relearning once routine movements affected by the temporary loss of blood flow in the brain.
Rehabilitation beds are just a short walk from the neuroscience center’s beating heart, a cavernous physical therapy gymnasium filled with specialized exercise equipment designed for the kind of tasks that, with proper guidance, can help re-activate damaged nerve pathways and rebuild atrophied muscle tissue.
It’s an exponential upgrade over Grossmont’s former gym, which filled a single hospital hallway.
Scott Evans, chief strategy officer and market CEO for Sharp HealthCare, pointed out a special “studio apartment” room just off the main gym floor. This space is configured with all of the equipment a person would need to use when they return home after a serious neurological incident, such as a stroke.
“This is where we can simulate the activities of daily living,” Evans said. “They can start practicing doing their own clothes again, washing the dishes, making meals, getting in and out of the bathtub.”
The center treats far more than strokes. Brain and spine tumors, complex spine surgeries, movement disorders such as Parkinson’s disease, and vision problems related to neurological conditions are also services allocated to the neuroscience hospital, which does not have its own dedicated operating rooms. Surgeries will be performed in Grossmont’s Burr Heart and Vascular Center that opened in 2019.
Many who use the new physical therapy gym will be staying in the hospital’s rehabilitation unit, working daily to regain function before they can be discharged home. But the facility is also open to outpatients, those who are already home, but who require ongoing specialized workouts to help them handle neurological conditions.
By 9 a.m. on a recent morning, a dozen people were already using the gym, including AJ Fiume, 27, a La Mesa resident with cerebral palsy. He spent time using a hand bike, then went through a specialized muscle-building session with a physical therapist.
“That was probably the second or third time I’ve been able to get on the bike like that in my life,” he said. “You know, it’s not like you can do this stuff at 24 Hour Fitness.”
There is more to come. An upstairs doctor’s office will be staffed by a full complement of neurological specialists.
The point, stressed Apel, is to put as many neurological services as possible in one centralized location, decreasing the amount of travel necessary to make appointments.
“You will be able to walk in there and see your neurosurgeon, stroke neurologist, rehabilitation physician … I mean, it’s almost a revolving door of what specialties will be available to patients in one location,” Apel said.
For now, stroke patients and others with emergency neurological problems must be pushed through long hospital corridors to get from the ER to the neuroscience hospital, which is on the opposite side of the sprawling medical campus.
But Evans said that there are plans for a much straighter and subterranean path in the future.
“We’re going to dig a tunnel right under there to connect directly with the emergency department,” the executive said, gesturing south toward Grossmont’s emergency entrance closer to Grossmont Center Drive. “That will make it even faster to get over here.
“We want to make it as fast as possible.”
