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Stroke: Stroke Unit Care and Endovascular Treatment Updates

Improving Access to Stroke Unit Care

Stroke unit care is a long recognized best practice, however in Ontario, there is regional variation in access, and patient outcomes. Identified by stroke system stakeholders as a priority to address, CorHealth has been engaged in detailed project planning for Phase 1 of this multi-year initiative. Phase 1 will target understanding capacity and access to stroke unit care across the provincial stroke system. This will include re-consideration and potential refinement of the current stroke unit definition to understand current state of stroke unit capacity and access and to describe the ideal future state. Gaps between current and ideal states of stroke unit care capacity and access will be quantified and assessed including identification of barriers and enablers. A stakeholder engagement approach, including patient and family engagement, is being developed as part of the project planning, and will be key to inform Phase 1 opportunities, recommendations, and implication considerations at local, regional, and provincial levels.

Endovascular Treatment (EVT) Update

This past summer, CorHealth and the Ministry of Health Provincial Programs Branch met with each of the eleven EVT program’s clinical and administrative leaders to review their past 3-year performance to understand contributing factors associated with performance variation. Common themes included: human resource availability, challenges with space or equipment availability, assembling the team quickly, and COVID-19. Each of the programs are in different states of working with hospitals in their stroke regions to support implementation of protocols to expand access. Programs were also asked to confirm their QI focus for the next 6 months, many addressing elements within the noted themes. A summary report will be created to capture common challenges, describe innovations used by sites performing well in certain areas and include links to resources where applicable. This approach is intended to support dialogue and share learnings across the province. CorHealth will be releasing the FY 2020/21 EVT performance report in late November.