Susan Groman, a registered nurse at Howard County General Hospital (HCGH), remembers asking a primary care doctor in Howard County to put her pamphlet about stroke risks and warning signs in his waiting room. He responded that it wasn’t necessary because most of his patients were not geriatric.

That was in 2009, shortly after she helped launch the hospital’s Primary Stroke Program with neurologist Eric Aldrich, M.D., Ph.D. She realized how much work was needed to educate the community. Among strokes, 10% to 15% occur in people from ages 18 to 50, according to a 2020 study.

Susan and her husband, cardiologist George Groman, M.D., will retire at the end of June after more than 30 years of improving cardiovascular care at Howard County General Hospital and in the community.

“George and Susan are shining examples of a deep commitment to a community hospital, and a commitment to health care in general,” says Dr. Aldrich.

Both George and Susan Groman have devoted their careers to diagnosing and removing clots that block blood flow to the heart or brain. “The amount of time that you’re not getting adequate blood flow to either is critical,” explains George Groman.

Treatments have improved considerably in the years since the Gromans started their careers. Medications can now dissolve clots, and minimally invasive procedures can remove them.
  
George Groman was a principal investigator for the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial at Howard County General Hospital, which proved the benefit of tissue plasminogen activator (tPA), a clot-busting drug. At that time, in the mid-1990s, Howard County General Hospital was not involved in clinical research, but George Groman connected with renowned Johns Hopkins cardiologist Eric Topol, M.D., so that the community hospital could participate.

“George came into the hospital to consent every single patient for the trial no matter what time of day or night,” says Michael Silverman, M.D., managing physician for Cardiovascular Specialists of Central Maryland, which is part of Johns Hopkins Regional Physicians. “He has been a pivotal physician in ensuring all citizens in Howard County had access to top quality care for acute cardiac syndrome.”

George Groman directed the primary angioplasty for acute myocardial infarction (PAAMI) program at the hospital from 2011 to 2016, which responds to signs that a patient is having a heart attack with immediate cardiac catheterization and, if needed, emergency angioplasty.

He was also instrumental in establishing the vascular ultrasound program at Cardiovascular Specialists of Central Maryland, which under his leadership received accreditation by the Intersocietal Accreditation Commission.

The Gromans have also devoted many hours to teaching emergency medical technicians (EMTs) at the Howard County Department of Fire and Rescue Services how to read electrocardiograms in the ambulances.

Though EMTs do not diagnose patients, they can reduce the time between event and treatment by recognizing the signs of a heart attack or stroke and alerting clinicians at the hospital so they will be ready when the ambulance arrives.

Susan Groman created a mechanism that gives emergency medical services staff members feedback about the patient’s diagnosis and outcome — information that they use to improve their procedures. The system became a model for other Maryland hospitals.

With Howard County General’s primary stroke program, Susan Groman co-leads a comprehensive system for rapid diagnosis and treatment of patients with a stroke.

Because of the program, the hospital was designated by the Maryland Institute for Emergency Medical Services Systems as a primary stroke center for the state. That means patients with acute strokes can receive emergency care at the hospital. More complex cases go to comprehensive stroke centers at The Johns Hopkins Hospital or Johns Hopkins Bayview Medical Center.

“She’s put her heart and soul into this program,” says Dr. Aldrich. “You just don’t meet a person like her very often. She’s an inspiration.”

Howard County General Hospital has received the American Heart Association/American Stroke Association’s Get with the Guidelines Target: Stroke Honor Roll Elite Gold Plus Quality Achievement Award.

Susan Groman also leads support groups for survivors of stroke and their caregivers, though they have been on hold recently because of COVID-19.

“Susan Groman is the reason HCGH has the outstanding stroke program that we do,” says Jennifer Baldwin, vice president of nursing and chief nursing officer for the hospital. “From competence, experience and sheer will, she has stood up this tremendous program. Her contributions have touched so many lives.”