Excellence in regional stroke care: an evaluation of the implementation of a stroke care unit in regional Australia

Abstract

OBJECTIVE: To assess the effectiveness of a formalised stroke service in a regional hospital. DESIGN: A pretest post-test design. SETTING: An acute stroke unit in a regional health service. PARTICIPANTS: Overall sample comprised 80 patients with 36 (45.0%) men. Forty patients (19 men, 21 women) comprised pre-intervention group and 40 (17 men, 23 women) post-intervention group. INTERVENTIONS: Establishment of an acute stroke unit. MAIN OUTCOME MEASURE(S): Increased frequency in meeting key performance indicators for acute stroke care as recommended by National Stroke Foundation. RESULTS: On discharge, fewer survivors in the pre-intervention group were independent (n = 5) and returned home (n = 9) than the post-intervention group (n = 13) for both independent and returned home. More survivors in the pre-intervention group were discharged to aged care or inpatient rehab (n = 22) than the post-intervention group (n = 12). Within required time frames, the frequency of CT scans (chi(2) (1, 80) = 4.1, P < 0.05), swallow assessments (chi(2) (1, 80) = 9.0, P < 0.01), occupational therapy assessments (chi(2) (1, 80) = 14.5, P < 0.0001), multidisciplinary meetings involving patient and family (chi(2) (1, 80) = 19.9, P < 0.0001) and self-management plans (chi(2) (1, 80) = 10.9, P < 0.05) all increased significantly. CONCLUSIONS: Our evaluation demonstrated that introduction of formalised stroke care to a regional hospital resulted in improved compliance with key performance indicators and better patient outcomes. Thus evidence-based specialised stroke care can be offered with confidence in regional populations.