Improving Stroke Care Through Patient Advocacy:  A Q&A with Natalie Niekro, Penumbra’s Director of Patient Programs

Having a stroke or brain aneurysm can be the beginning of a life-altering journey. At Penumbra, we create innovative devices designed to improve patient outcomes — but the intervention is only the start of that journey. Natalie Niekro serves as director of patient programs at Penumbra. Her work bridges healthcare institutions, physicians, and patients, providing programs and resources to strengthen recovery and improve quality of life over the long haul.

Natalie brings passion and authenticity to her mission. She is both a patient advocate and a brain aneurysm survivor herself — and the daughter of MLB pitcher, Joe Niekro, who suffered a fatal brain aneurysm in 2006. As founder of The Joe Niekro Foundation, Natalie continues to keep her father’s legacy alive while driving groundbreaking change in neurological care and research for patients all over the country.

We recently spoke to Natalie to learn more about Penumbra’s patient advocacy programs for stroke patients.

Q: What is the focus for your patient advocacy work?

Natalie Niekro: 2025 was really an instrumental year for patient advocacy. We’ve been able to make a significant difference in the hospitals that we’ve worked with. We’ve focused a lot on emergency medical services (EMS) outreach, which has been incredible, because we found that many hospitals don’t realize how important education, outreach, and relationships with EMS really are. We’ve worked with several hospitals on improving their relationships with EMS, which in turn has made significant differences in their stroke care and their overall volume.

Q: What kind of programming does your team develop with hospitals?

Natalie Niekro: Whenever I meet with a hospital, everything we put together is customized, depending on their needs. Every hospital has different priorities.

My role is to look at their challenges, their goals, and then help them put together a program that will accomplish those goals.

We found that the top three complaints from EMS are that they feel undervalued and unappreciated, they want better communication when they drop off a patient, and they want to know what happens to that patient after treatment. We’ve helped hospitals put together programs that address those three challenges, and we’ve seen major differences in their EMS relationships.

EMS is crucial, because they’re the first people a patient sees before getting to the hospital. If you don’t have a good relationship with EMS, it can really harm your system.

Q: How does the relationship between a hospital and EMS teams impact patient care?

Natalie Niekro: Good relationships with EMS can make a significant difference in overall stroke care. In many states there are not specific protocols for where EMS is to take a stroke patient and we are working diligently to fix that. Patients are often taken to a hospital that isn’t best fit for the treatment they need and when we are talking about stroke, “time is brain,” so time is of the essence.

That’s what the Get Ahead of Stroke initiative is about — making sure patients get to the right facility in the least amount of time. Many hospitals are not following those guidelines, and the thing that’s damaged the most is the patient and their outcome.

We help hospitals implement programs to make sure patients are getting to the right hospital as quickly as possible. That leads to better outcomes, better EMS relationships, and a decrease in readmission rates. We don’t want to see patients coming back — we want them treated effectively and safely.

Q: How does patient advocacy extend beyond the acute treatment phase?

Natalie Niekro: Treatment does not end when the procedure is over. There’s a long recovery journey, and patient programs are designed to ensure hospitals can support patients through the recovery process.

I’m amazed at how many stroke-treating hospitals don’t have a stroke support group. To me, every stroke hospital should have one. Simple programs like these benefit patients, the community, and the hospital. That’s what patient programs are all about.

Q: Why is this work such a passion point for Penumbra?

Natalie Niekro: Penumbra is a unique company because it understands the importance of covering the patient from A to Z across the entire care journey, making sure patients are treated safely and effectively.

But it doesn’t end there. We work to bridge the gap between what happens once the patient is treated and when they get home and realize they need additional support. No other company does this. Hospitals are often surprised and grateful that we’re able to provide this type of partnership and education.

We offer educational tools for hospitals to help patients understand the recovery journey. That’s so important, because patients and families aren’t prepared for what’s to come. We want to help them be prepared.

Q: What were some of the most impactful programs recently?

Natalie Niekro: Some of the best programs we accomplished in 2025 were the implementation of nine new stroke support groups across the country. These have been beneficial for patients and families, as well as for hospitals.

When healthcare professionals attend support group meetings and hear what patients go through after treatment, it helps build empathy and a better understanding of how to keep stroke programs strong and effective.

Q: What’s in store for 2026?

Natalie Niekro: In 2026, we’re going to continue expanding patient programs. I work closely with stroke coordinators, stroke managers, stroke physicians, and stroke teams to make sure they have strong stroke programs in place.

Q: Any final thoughts?

Natalie Niekro: I’m grateful Penumbra is committed to caring for patients, both with its continued product innovation and through its support of patient programs development. When those resources are utilized, they make a real difference for hospitals in the long run.

Important Safety Information

Additional information about Penumbra’s products can be located on Penumbra’s website at  https://www.penumbrainc.com/products/neuro-embolization-system/. Caution: Federal (USA) law restricts these devices to sale by or on the order of a physician. Prior to use, please refer to Instructions for Use for complete product indications, contraindications, warnings, precautions, potential adverse events, and detailed instructions for use. Risk information can be found at peninc.info/risk.