Stroke care system passes annual exam: steady progress being made

TORONTO, June 18, 2012 /CNW/ - A detailed evaluation of the province's stroke care system shows patients are receiving better care, and there is still room for more improvement.  Today, the Ontario Stroke Network (OSN) and the Institute for Clinical Evaluative Sciences (ICES) released a report card that compares the level of access, treatment and rehabilitation of people who suffer strokes across the province, showing that wait times for preventive surgery and diagnostic testing are being reduced across the province.

Each Local Health Integration Network (LHIN) received its own detailed report card, which shows the progress being made, and will be used to review gaps and identify solutions that will further enhance the stroke care system. A first in Canada, the OSN stroke report cards, introduced in 2011, grade the delivery of care for each of Ontario's 14 LHINs providing data on stroke care and service, both regionally and provincially.

"While these results are encouraging, the detailed analysis shows that we still have a way to go in stroke rehabilitation and in making sure that everyone understands the signs and symptoms of strokes so patients can get care as quickly as possible," says Christina O'Callaghan, Executive Director of the Network.

Shannonville Ontario mom Brandy Englesdorfer knows first-hand about how the report cards are improving access and care.  She suffered a stroke just one month before her 36th birthday. Englesdorfer had prepared breakfast for her three children and suddenly experienced extreme vision problems.  She instructed her five year-old daughter to call 911.

When Englesdorfer arrived at Belleville General Hospital, staff activated their Code Stroke process which links to several report card indicators including access to the drug tPA, which destroys blood clots and can limit stroke damage.  "Being able to arrive quickly to hospital, getting the tPA, having in-hospital and outpatient rehabilitation—has given me back my life," says Englesdorfer. "I'll get to see my kids grow up."

The following areas of improvement in stroke care were identified in the report:

  • Reduced LHIN variation and increased percentage of stroke/TIA patients arriving by ambulance and also receiving a brain scan within 24 hours of hospital arrival;
  • Increased percentage of patients receiving the clot-busting drug for stroke within 60 minutes and more LHINs are achieving this benchmark;
  • Increased percentage of patients accessing stroke unit care;
  • Reduced in-hospital, 30-day and one-year stroke mortality rate;
  • Reduced wait times for admission to inpatient rehabilitation from acute care.

The report cards both illustrate the progress being made and also demonstrate to the LHINs where further improvements are needed. "The report cards' concise presentation makes this a very useful tool," says Mimi Lowi-Young, CEO of the Central West LHIN.  "It allows us to quickly identify gaps, prioritize investments and improve care."

Some of the recommendations made by the report include:

Improve public awareness of signs, symptoms and stroke risk factors

Stroke can be prevented by better management of risk factors, such as hypertension, heart disease, diabetes, atrial fibrillation and smoking. Once a stroke is suspected, the faster patients get to hospital, the better their chances of receiving treatments that could help minimize the effects of the stroke.

Improve access to secondary prevention clinics for TIA patients

Patients who display symptoms of a minor stroke or transient ischemic attack must undergo a comprehensive evaluation to confirm the diagnosis and begin treatment to reduce the risk of major stroke.

Admitted stroke patients need to be cared for in a stroke unit

Acute stroke patients, admitted to the hospital should be cared for by a team of experts in stroke, preferably in a special dedicated unit. Expert care results in reduced complications and decreased death and disability.

Improve access and appropriateness of rehabilitation following acute stroke

People who have difficulty with daily activities should have access to rehabilitation therapy services to improve or prevent deterioration in these activities.

Pediatric stroke care needs attention

The first ever Ontario pediatric stroke data shows important gaps that could be improved by the implementation of a specialized pediatric stroke program in the province.

The Ontario Stroke Network (OSN) www.ontariostrokenetwork.ca, created in 2008, is a non‐profit organization funded by the Ministry of Health and Long‐Term Care. OSN provides leadership for the Ontario Stroke System, which represents 11 regional stroke networks that support the LHINS.  The Canadian Stroke Network and ICES collaborated with OSN in creating the evaluation report and stroke report cards.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

June is Stroke Awareness Month, an opportunity for Canadians to learn about strokes and their warning signs, as well as how to reduce the odds of experiencing a stroke.  Strokes are one of the leading causes of death, disability and illness in Canada. To learn more about stroke warning signs and how to reduce the risk of developing a stroke, contact www.ontariostrokenetwork.ca.

The report can be found at:  www.ices.on.ca/webpage.cfm?site_id=1&org_id=68

SOURCE Ontario Stroke Network

For further information:

Amorell Saunders N'Daw (416 706 2401)
Shelley Romoff (647 938 1933)
Ontario Stroke Network
Amorell@idirect.com
shelley.romoff@rogers.com
info@ontariostrokenetwork.ca 

Deborah Creatura
ICES
416-480-4780 or cell: 416-904-4547 
Deborah.creatura@ices.on.ca

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Ontario Stroke Network

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