🏅Your Path to Certification
Earn your way up three evidence-based tiers. Each builds on the last. Finish all three and receive your Certified Prepared Patient · Stroke badge and printable certificate, recognized across the FFH Network.
Aware · Identity: Self-Advocate
You know your body and your disease. Layer 1 — Condition Literacy.
- Complete Modules 1–4 (Condition Literacy)
- Pass the "Time Is Brain — What Stroke Is" quiz (≥80%)
- Identify your stroke type (ischemic, hemorrhagic, TIA) and brain region affected
- Build your home pain plan + trigger list
Active · Identity: Care Team Member
You partner with your team and navigate the system. Layer 2 — Care & System Literacy.
- Complete Modules 5–7 (Visits · Team · Insurance/Referrals)
- Demonstrate teach-back on your secondary-prevention regimen
- Complete one "great visit" prep + debrief
- Build your When-to-Call plan + Care Team card
- Successfully resolve one prior auth or referral
Certified Prepared Patient · Identity: Ambassador
You teach, mentor, fight stigma, and shape research & policy. Layer 3 — Advocacy & Ambassadorship.
- Complete Modules 8–10 (Stigma · Teach/Mentor · Research/Policy)
- Mentor 1 person OR present at a support group / school
- Sign the Prepared Patient Pledge
- Generate & share your Health Passport
- Submit one advocacy action (legislator letter, trial review, board nomination, or policy comment)
📋Master Pre / Post Assessment
Where You Stand — Confidence Before & After
Seven dimensions of being a Prepared Patient. Answer once at the start of your journey and again at the end. Your goal is to see real growth across understanding, self-management, communication, and optimal utilization — knowing when to call your team, when to use Day Hospital, and when to go to the ER. Your answers stay on this device unless you choose to share with your clinician.
📈 Your Pre→Post Growth
📞Know Who to Call — Before the ER
Stroke recovery means a lot of small questions and a few real emergencies. Knowing the right number to call — your stroke team, your urgent line, or 911 — saves time, money, and brain. Save these numbers in your phone today. The numbers below are placeholders — your institution will fill in the right ones for you.
🌡️ Fever ≥ 101°F (38.5°C) — call within 1 hour
Any sudden BE-FAST symptom (Balance, Eyes, Face, Arm, Speech) is 911 — never drive yourself, never have a friend drive. Note the last known well time. EMS routes you to the right stroke center and pre-notifies the team. For non-acute stroke questions, call [Vascular Neurology On-Call: (555) 222-9000] 24/7.
🩹 Pain crisis you can't break at home — call before going anywhere
For non-acute concerns (BP running high, missed med, mild new symptom that doesn't fit BE-FAST, side effect, post-stroke depression), call your [Stroke Care Manager: (555) 222-9100]. They can usually triage you to the right next step within hours.
💬 Routine questions, refills, scheduling
Use [MyChart portal] first — most messages answered within 1 business day. For meds about to run out (especially anticoagulants — never let them lapse), call [Stroke pharmacy line: (555) 222-9050].
🚑 Call 911 right away for any of these
Sudden one-sided weakness · face droop · slurred speech · sudden severe headache · sudden vision change · sudden balance loss or vertigo · trouble understanding speech. Any one of these is BE-FAST positive. Call 911 immediately — never drive yourself, never have a friend drive. Note the last known well time.
📚Condition Literacy & the 10 Prepared Patient Competencies
A Prepared Patient builds three kinds of health literacy — and grows into three identities. Each competency works through the FFH three pillars: Learn It · Live It · Share It.
Advocate for Self
You speak up for your own care, plan, pain, and goals.
Care Team Member
You partner with your team — not above, not below.
Ambassador
You teach, mentor, and shape research, policy & access.
🧬 Condition Literacy Learn It · Tier 1 Aware
"I know my body and my disease." The foundation. Without this, nothing else holds.
Time Is Brain — What Stroke Is
Ischemic vs hemorrhagic vs TIA. Why every minute matters. The 4.5-hour clot-buster window and the 24-hour thrombectomy window. Where to go and how fast.
Know My Numbers & Risk Factors
BP, A1c, LDL, AFib status, OSA status, family history, the AA Stroke Belt disparity. Goal numbers and how to read your own labs.
Lifestyle Force Field
Mediterranean / DASH eating, 150 min/week movement, sleep, stop smoking, alcohol moderation, treated sleep apnea. Stack three levers and you out-perform many single drugs.
Master My Secondary-Prevention Meds
Antiplatelet OR anticoagulant if AFib, high-intensity statin, BP meds to goal, diabetes meds to goal. Adherence is the #1 lever you control.
🤝 Care & System Literacy Live It · Tier 2 Active
"I'm part of the team. I navigate the system." Where most preventable ER visits, readmissions, and frustration happen — and where this course pays off the most. Optimal utilization lives here.
Self-Monitor at Home
Validated upper-arm BP cuff, AFib-capable smartwatch, symptom journal, sleep tracking, STOP-BANG. The data that moves treatment between visits.
BE-FAST · When to Call vs Go to ED
Balance · Eyes · Face · Arm · Speech · Time. Any one symptom = call 911. Last known well time. TIA warning signs. Why driving is never the right answer.
Comorbidity Awareness · The 5-Way Cluster
SCD, HTN, OSA, T2D as inputs — Stroke as the named outcome. TIA as the warning the cluster sends. The Ambassador / family-observer role across all four.
📣 Advocacy & Ambassadorship Share It · Tier 3 Certified
"I speak up. I lift others. I shape the future." This is what turns a Prepared Patient into a force multiplier for the whole community.
Family, Care Team & the Rehab Continuum
Vascular neurology, PCP, cardiology if AFib, PT/OT/SLP, RN care manager, pharmacist, behavioral health, peer mentor. Acute → IRF → SNF / home health → outpatient.
Teach BE-FAST · Mentor · Ambassador
The person most likely to recognize your stroke is a loved one, not a doctor. Teach BE-FAST. Mentor a survivor. Speak at your church, employer, or school.
Mastery, Survivorship & Graduation
Earn Certified Prepared Patient · Stroke. Then run the survivorship rhythm: yearly review of every prevention number, peer-mentor track, annual recertification.
👥My Care Team
Your team is bigger than just the doctor. Click any card to edit, or click the + tile to add a new team member. Saved on this device. The Force Field Emergency Card below auto-syncs from this list. Edit the CARE_TEAM_DEFAULTS array in the script block to set the starter roster for Stroke.
📖Glossary — words you'll hear
Plain-English definitions for terms doctors and labs use. Tap to expand.
Ischemic stroke
Hemorrhagic stroke
TIA (Transient Ischemic Attack)
BE-FAST
Last known well time
tPA / tenecteplase (clot-buster)
Mechanical thrombectomy
Atrial Fibrillation (AFib) & CHA₂DS₂-VASc
Antiplatelet vs Anticoagulant
Comprehensive vs Primary Stroke Center
🧪Lab Test Tutor — what your numbers mean
Lab Test Tutor — what your numbers mean
Don't just see a number — know what it means and what to ask. Your "normal" may be different from a friend's. Ask your hematologist to write your personal baseline in the column on the right.
| Test | What it measures | Typical adult range | What to ask if it's off | My baseline |
|---|---|---|---|---|
| BP (Blood Pressure) | The #1 modifiable stroke risk factor. Use 7-day home averages. | Goal: <130/80 (often lower after stroke) | Am I at goal? Any med change needed? | [fill in] |
| A1c | 3-month average blood sugar. | Goal <7% if diabetic | Should we add an SGLT2 or GLP-1 for cardio benefit? | [fill in] |
| LDL cholesterol | Drives plaque buildup; lower = less recurrence. | Often <70 (sometimes <55) on high-intensity statin | Am I on a high-intensity statin? Is my LDL at goal? | [fill in] |
| INR (if on warfarin) | How thin your blood is on warfarin. | Usually 2.0–3.0 (target varies) | Am I in range? When is my next check? | [fill in] |
| CHA₂DS₂-VASc (if AFib) | Yearly stroke risk in AFib. | Anticoagulate if ≥2 men, ≥3 women | What is my score and am I anticoagulated? | [fill in] |
| Creatinine / eGFR | Kidney function — drives med dosing. | eGFR >60 generally favorable | Does my kidney function affect my anticoagulant choice? | [fill in] |
| Carotid Doppler ultrasound | Looks for narrowing of the carotid arteries (carotid stenosis). | >70% stenosis may need procedure | Do I have a recent carotid Doppler? Any stenosis? | [fill in] |
| Sleep study (PSG / home test) | Diagnoses obstructive sleep apnea — a big stroke driver. | AHI ≥5 = OSA; treat with CPAP | Have I been screened? Should I get a sleep study? | [fill in] |
➕Add-On Modules & Earnable Badges
Stackable modules that match your situation. Complete one to earn an extra badge on your certificate. Your institution can add their own.
👶 Pregnancy after Stroke
Pre-conception counseling, BP targets, anticoagulation choice, anesthesia plan, postpartum stroke risk.
🌱 Transition to Adult Care
Ages 14–25. Build your portable summary and meet your adult team.
🧪 In a Clinical Trial?
Add: protocol literacy, side-effect tracking, when to call the study coordinator vs your usual team.
💉 Considering Gene Therapy / HCT
Eligibility, fertility preservation, what the conditioning weeks look like, follow-up.
✈️ Travel after Stroke
Time-zone meds (esp. anticoagulants), DVT prevention on long flights, packing your Passport, finding a stroke center abroad.
🎓 At School / At Work
Sample 504 plans, ADA accommodations, cooling breaks, how to talk to teachers/HR.
👨👩👧 For Caregivers & Siblings
How to feel for the spleen, what to put in the go-bag, taking care of yourself.
+ Add Your Institution's Module
Drop in your own — chemo ed, infusion-pump training, port-access teach-back, anything.
🛡️Force Field Emergency Card
🛡️ Force Field Emergency Card FRIDGE · WALLET · EMT-READY
A one-page emergency record for any EMT, ER, new doctor, or transition visit. Print one for the fridge, one for your wallet. Updates anytime. This is the document you hand to a stranger when you can't speak for yourself.
🤝 My Care Team — call list for any clinician picking up my care
📘My Health Passport
📘 My Health Passport PATIENT-OWNED JOURNAL
This is your record — not your hospital's. Log every visit, capture every question for next time, and watch your own trends. Many of you get care at more than one hospital, on more than one record system. This Passport travels with you. Future versions will let you import data directly from your patient portals (the "Blue Button" vision).
🩺Working With a Prepared Patient
Your patient is going through a structured, evidence-based course. Here's how to get the most out of every visit, reduce ER use, and partner well. Built on the AHRQ SHARE Approach, the IOM teach-back method, and the 2021 AHA/ASA Secondary Prevention guideline and the 2024 AHA/ASA Acute Ischemic Stroke guideline update.
The SHARE Approach — your 5-step playbook
Use these steps in any order. Cycle back. Use teach-back at every transition. Source: AHRQ Pub. No. 25-0005 (Oct 2024).
💬Teach-Back & Risk Communication
The two highest-yield, lowest-cost SDM techniques. Use both at every visit.
🔁 Teach-Back (1–2 min)
- "Just so I know I explained it well — what would you tell your sister about why we're starting apixaban (or your statin)?"
- Open-ended ("what" / "how"), not yes/no.
- If they get it wrong: "I must not have explained it well — let me try a different way." Then teach-back again.
- Use it for: BE-FAST recognition, anticoagulation plan, BP self-measurement, when to call you vs 911, rehab home program.
- Document teach-back in your note — it's a quality measure and a billable element of care.
🔢 Communicating Numbers
- Use absolute risk, not relative. "13 out of 100" beats "13%" beats "1 in 8" beats "low risk."
- Keep denominators & timeframes constant when comparing options.
- Show, don't tell: icon arrays, Wong-Baker FACES, written summary.
- For lab numbers: give the action threshold, not just the value. "Your ferritin is 1,200 — over 1,000 we usually start iron removal."
⚠️Stroke-Specific Clinical Guardrails
Acute / ED
- BE-FAST positive → call code stroke, get NIHSS, non-contrast CT within 20 min, last-known-well time documented.
- tPA / tenecteplase within 4.5 hr if eligible. Door-to-needle target <60 min (best <30).
- Mechanical thrombectomy for LVO up to 24 hr (DAWN/DEFUSE-3 imaging criteria). Transfer to CSC if needed — don't delay.
- BP management ischemic: permissive HTN unless >185/110 pre-tPA; hemorrhagic: aggressive lowering to <140 SBP per INTERACT-2 / ATACH-2.
- Reverse anticoagulants for hemorrhagic stroke (PCC for warfarin, andexanet/idarucizumab for DOACs).
Outpatient / Secondary Prevention
- Confirm BP <130/80 home average; intensify if not at goal.
- High-intensity statin standard for ischemic stroke; LDL target often <70.
- Antiplatelet for non-cardioembolic; anticoagulant replaces antiplatelet for AFib (CHA₂DS₂-VASc).
- Screen for AFib post-stroke (extended monitoring 14–30 days when cause unclear).
- Screen for OSA (STOP-BANG); treat with CPAP — adherence ≥4 hr/night cuts recurrence.
- Screen for post-stroke depression (very common, very treatable; SSRI + CBT).
- Carotid Doppler if not done; intervention if symptomatic stenosis >70%.
🌍Cultural Competence & Trust
Stroke disproportionately affects African American populations (~2× incidence, onset ~10 years earlier) and the southeastern U.S. "Stroke Belt." Bias in EMS response, ED triage, and thrombectomy access is well documented. Repair starts in your office.
- Start with belief. Symptoms are what the patient says they are. Subtle BE-FAST presentations, posterior strokes, and TIAs are real and often dismissed.
- Ask about their model. "What do you think causes a crisis for you? What do you think helps?" Use that language.
- Use qualified medical interpreters — never family, never minor children except in true emergencies.
- Invite the family in. Decisions about transition, transplant, gene therapy, fertility, pregnancy are family decisions in many cultures.
- Name the bias. "I know stroke symptoms in younger and Black patients are often dismissed in ERs. We track that here, and you can tell me if it ever happens."
🏥Customize for Your Institution
Clone this course and replace the highlighted blocks with your own information. Each editable field below is a placeholder — change it once and it propagates through the patient view.
📞 What Should Replace the When-to-Call Block
- 24/7 hematology on-call number
- Stroke clinic / rehab outpatient hours & address
- Specialty pharmacy line
- Behavioral health / crisis line
- Patient portal login URL
👤 Who Is Your "Susan"?
- Name, role, photo, calendly/booking link.
- What teach-back / device check-ins they own (home BP cuff, anticoagulant adherence, CPAP, AFib watch alerts).
- How patients reach them between visits.
📚 Add Your Own Modules
- Your clinical trial protocols (chemo ed, gene therapy run-up).
- Local 504 plan template, school-letter template.
- Insurance & financial-aid pathways.
- Local peer support partners (e.g., AHA Stroke Connection, regional stroke survivor groups).
🎨 Re-skin in 2 Lines of CSS
--inst-primary: your brand color- Replace the FFH × American Stroke Association × [Your Institution] cobrand pill in the hero
- Drop in your logo PNG (white version) — same 48px height as FFH logo
📚 Evidence Base — what this course is built on
- AHRQ SHARE Approach — 5-step shared decision making framework. AHRQ Pub. 25-0005, Oct 2024. ahrq.gov/sdm
- AHRQ Health Literacy Universal Precautions Toolkit (3rd ed.) — teach-back, plain language, accessible materials. AHRQ Pub. 23-0075, March 2024.
- AHA/ASA Guideline for the Prevention of Stroke in Patients With Stroke and TIA (2021) — secondary-prevention bundle, antithrombotic choice, BP/lipids/glucose targets, lifestyle.
- AHA/ASA Guidelines for the Early Management of Patients With Acute Ischemic Stroke (2019, 2024 update) — BE-FAST, tPA / tenecteplase, thrombectomy criteria, door-to-needle / door-to-puncture.
- AHRQ PEMAT — Patient Education Materials Assessment Tool. Used to grade understandability & actionability.
- Stanford Chronic Disease Self-Management Program (CDSMP) — peer-led, self-efficacy backbone of the Tier 3 advocacy work.
- AHRQ Patient Activation Measure (PAM) — the "Aware → Active → Certified" ladder maps to PAM levels 1–4.
- American Stroke Association (stroke.org) — community partner content, BE-FAST campaign, peer mentors via Stroke Connection.
- FFH Prepared Patient · Asthma course — sister course in the FFH Academy; this build mirrors its structure for series consistency.
Course content is educational and not a substitute for medical advice from your own clinicians. Institutions cloning this course are responsible for accuracy of all customized blocks.