Study: Stroke patients receiving better care

A comprehensive evaluation of the province’s stroke care system shows patients are receiving better care, according to a study released today.

The Ontario Stroke Network (OSN) and the Institute for Clinical Evaluative Sciences (ICES) today released a report card that compares the level of access and treatment of people who suffer strokes across the province, showing that the majority of indicators and benchmarks have improved since the previous three-year performance study.

The report card shows that significant progress has been made towards helping to drive improvements in stroke prevention and care in Ontario. Provincially, the report card shows statistically significant improvement in 15 of 19 indicators. Additionally, 14 of 17 Benchmarks have also improved.

“The report cards are critical to measuring care against targets for access to best practices at the local level,” said Mark Bayley, Medical Director, Brain and Spinal Cord Rehab Program, UHN-Toronto Rehab Institute. “They serve to set the bar higher for stroke care in Ontario.”

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.

The provincial report card reflects significant improvement in the indicators for stroke prevention, acute management and rehabilitation:

• Increased the proportion of patients who arrived at an emergency department less than 3.5 hours from stroke symptom onset
• Reduced 30-day and stroke mortality rate
• Increased percentage of stroke/TIA patients receiving a brain scan within 24 hours of hospital arrival
• Increased percentage of patients receiving the clot-busting drug for ischemic stroke
• Increased the percentage of stroke patients discharged from acute care who received a referral for outpatient rehabilitation

The report cards, part of a larger Ontario Stroke Evaluation Report scheduled for release in September, illustrate the progress being made and also demonstrate to the LHINs where further improvements are needed. This is an important achievement given the complexity of making changes in healthcare. The OSN and the Regional Stroke Networks are well positioned to implement further innovations.

“While steady progress is being made, there is a need for further regional approaches to increase access to stroke unit care, which is a key step in addressing variation in patient outcomes,” said O'Callaghan. O’Callaghan said that “the OSN will continue its vital collaboration with Ontario’s 11 Regional Stroke Networks to align operating plans, education, knowledge translation and public awareness efforts and implementation strategies in advancing access to best practices to continually improve report card process and outcome indicators.”

You can view the report cards at ICES.

The Ontario Stroke Network provides provincial leadership and planning for the continuum of stroke care in Ontario—from health promotion and stroke prevention to acute care, recovery, rehabilitation and reintegration.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare 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.