Organization of Emergency & Acute Care
Grouping patients in stroke units where care is provided by multidisciplinary stroke teams improves the delivery of coordinated treatment. There are few locations in B.C. where this occurs. Numerous studies have shown that organized and well-managed stroke units dramatically improve the outcome of stroke patients. Stroke units reduce mortality, average length of hospital stay and costs, and improve functional abilities of patients at discharge.
Stroke units have been shown to reduce the odds of death by 17 per
cent, increase the ability to live at home by 7 per cent and reduce
the length of stay by 8 per cent compared to care provided on a general
ward.
Stroke units facilitate:
- Early recognition of acute stroke signs and symptoms.
- Rapid treatment by health professionals trained in evidence-based stroke care.
- Information exchange, constant updating of training for professionals, and easier uptake of better practice guidelines such as The Stroke Treatment Education Program (STEP) and Next STEP.
- Within a regional system, organize stroke care in an integrated model, with evidence-based stroke protocols and clinical care pathways. Dedicated stroke teams and stroke units should be in place to deliver care on a 24/7 basis at the maximum number of care centres. Stroke teams should include members from physiatry and physio/occupational/speech therapy, in order to better link acute care services with rehabilitation services (this rehabilitation involvement in the early stages of care should not be limited to assessment, but should prioritize the initiation of rehabilitative treatments as early as possible). Consideration should be given to salary supplements for stroke team members.
- Through a human resources plan, develop recruitment strategies and increase the number of healthcare professionals dedicated to stroke, who can play a role on stroke teams.
The following prototype projects are underway in B.C. as part of the BC Stroke Strategy: