Since 2011, annual stroke report cards and progress reports have been a key resource for Ontario’s 11
regional stroke networks. The information they provide drives system change and allows for
planning across the province.
This 2018 report marks the eighth edition of the provincial and LHIN report cards, capturing data from
2016/17 fiscal year. The quality of stroke care continues to improve in Ontario. Performance in 2016/17
compared to 2015/16 demonstrates the following:
The median door to needle time decreased by 3 minutes to 47 minutes and the rate of tPA (12.5%) exceeded
the minimum rate understood to impact disability at a population level (12%)
The proportion of individuals with stroke or TIA discharged from the ED and referred to secondary
prevention care increased to 77.3%
The proportion of inpatient stroke rehabilitation patients achieving a length of stay target appropriate
to their disability increased by almost 4 percentage points to 66.4%
The 30-day readmission rate for any reason following a stroke/TIA decreased from 7.6% in 2015/16 to 7.0%
Despite improvements, Ontario’s stroke report card identified wide variation across the province in
delivering best practices on many indicators, which means that people receive different quality of care
depending on where they live or receive that care.
Additionally, Ontario’s stroke rehabilitation sector is under pressure to provide the 180 minutes per day of
direct therapy that is recommended by stroke quality-based procedures (QBPs). Current performance is only 65
minutes per day.
It is estimated that if all LHINs performed at benchmark levels:
- 6,039 more patients would have access to stroke unit care,
743 more patients would receive tPA, and
827 more severe stroke patients would have access to inpatient rehabilitation.
The report cards and progress reports revealed Ontario’s stroke system is continuing to improve the
of best practice care and the benchmarks for high quality care are being set higher in the absence of
financial incentives. For the full report, click here.